MEDICARE: MS. LINDSA LUINSTRA

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	2255A2300X	Athletic Trainer	24-00820	KS

General Provider Information

NPI Number	:	1568866994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDSA LUINSTRA

Provider Business Mailing Address
First Line	:	300 E 27TH ST
Second Line	:
City	:	NORTH NEWTON
State	:	KS
Zip	:	67117-8061
Country	:	US
Telephone Number	:	316-284-5384
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 27TH ST
Second Line	:
City	:	NORTH NEWTON
State	:	KS
Zip	:	67117-8061
Country	:	US
Telephone Number	:	316-284-5384
Fax Number	:

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

Provider Enumeration Date	:	10/14/2014
Last Update Date	:	10/14/2014

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