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General NPI Number Information
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NPI Number | 1497486799
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Entity Type | Individual
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Provider Name | LINDSY M VARGAS GUEVARA CSFA
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Gender | Female
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Dates
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Enumeration Date | 06/19/2022
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 2300 MARGOT ST APT 2406
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-9519
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Country | US
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Telephone | 678-294-9735
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1104
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City | GRAYSON
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State | GA
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Zip | 30017-0022
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Country | US
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Telephone | 678-294-9735
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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