MEDICARE: LINDSEY CAROL ROBERTS FNP

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	363L00000X	Nurse Practitioner	71010891A	IN

General Provider Information

NPI Number	:	1336734938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY CAROL ROBERTS FNP

Provider Business Mailing Address
First Line	:	302 N MAIN ST
Second Line	:
City	:	KIRKLIN
State	:	IN
Zip	:	46050-9044
Country	:	US
Telephone Number	:	317-764-1233
Fax Number	:

Provider Business Practice Location Address
First Line	:	3728 S REED RD
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-3829
Country	:	US
Telephone Number	:	765-626-7110
Fax Number	:	765-450-4495

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

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	07/06/2022

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