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General NPI Number Information
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NPI Number | 1295100923
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Entity Type | Individual
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Provider Name | LINDSEY PFAU MS RD LD/N
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Gender | Female
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 210 CODY AVE
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City | HURLBURT FIELD
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State | FL
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Zip | 32544-5305
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Country | US
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Telephone | 413-265-5243
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 N MERIDIAN RD APT A
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5035
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Country | US
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Telephone | 413-265-5243
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | ND6685
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1089890
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License Number State | FL
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