=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235588518
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY SHEA MCCRANIE SEAGRAVES NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2016
-----------------------------------------------------
Last Update Date | 10/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1007 GREENFIELD DR
-----------------------------------------------------
City | TIFTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31794-3795
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-382-9733
-----------------------------------------------------
Fax | 229-387-6161
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 907 18TH ST E STE 400
-----------------------------------------------------
City | TIFTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31794-3684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-353-3422
-----------------------------------------------------
Fax | 229-353-6060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | NP202578
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------