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General NPI Number Information
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NPI Number | 1841545506
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Entity Type | Individual
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Provider Name | LINDSEY MIRANDA STAGGERS-GARDNER RN, MSN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 101 BRADDOCK RD
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City | FROSTBURG
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State | MD
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Zip | 21532-2303
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Country | US
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Telephone | 301-687-4310
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Fax | 301-687-7050
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Provider Business Mailing Address
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Address Line | 155 WILLOW AVE
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City | KEYSER
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State | WV
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Zip | 26726-3019
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Country | US
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Telephone | 304-790-0616
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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 | R201919
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License Number State | MD
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