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General NPI Number Information
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NPI Number | 1255148987
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Entity Type | Individual
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Provider Name | LYNDSEY EVANS
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 3500 W INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32124-1026
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Country | US
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Telephone | 407-906-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 PHAM DR
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City | PORT ORANGE
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State | FL
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Zip | 32129-7404
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Country | US
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Telephone | 386-631-8918
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11037679
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9325516
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License Number State | FL
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