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General NPI Number Information
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NPI Number | 1235389701
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Entity Type | Individual
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Provider Name | LINDSEY MEREDITH DIAZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 8809 N UNION BLVD SUITE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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Country | US
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Telephone | 719-548-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 5575 TECH CENTER DR SUITE 106
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-2353
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Country | US
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Telephone | 719-548-0700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60235184
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA4400
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA-602
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License Number State | AL
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