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General NPI Number Information
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NPI Number | 1295183069
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Entity Type | Individual
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Provider Name | LINDSAY THIEMKEY GORDON DNP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 2200 TYDD ST
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City | EUREKA
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State | CA
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Zip | 95501-1284
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Country | US
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Telephone | 707-441-1624
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Fax | 707-441-1253
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Provider Business Mailing Address
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Address Line | 3170 WILLOWCREEK RD
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City | PORTAGE
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State | IN
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Zip | 46368-4424
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Country | US
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Telephone | 219-764-7236
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28200956A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95029878
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License Number State | CA
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