MEDICARE: LINDSAY CATHERINE RADCLIFFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	275873	AZ

General Provider Information

NPI Number	:	1033858261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY CATHERINE RADCLIFFE

Provider Business Mailing Address
First Line	:	225 S ORLANDO ST
Second Line	:
City	:	FLORENCE
State	:	AZ
Zip	:	85132-6985
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 S ORLANDO ST
Second Line	:
City	:	FLORENCE
State	:	AZ
Zip	:	85132-6985
Country	:	US
Telephone Number	:	520-723-6893
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2022
Last Update Date	:	08/19/2022

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