MEDICARE: MRS. LINDSAY ANN MARTIN ARNP

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	3005833	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000790196	OTHER	KY	ANTHEM BCBS

General Provider Information

NPI Number	:	1790930709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSAY ANN MARTIN ARNP

Provider Business Mailing Address
First Line	:	PO BOX 15242
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4047
Country	:	US
Telephone Number	:	270-575-1010
Fax Number	:	270-575-1007

Provider Business Practice Location Address
First Line	:	2670 NEW HOLT RD STE C
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7506
Country	:	US
Telephone Number	:	270-575-1010
Fax Number	:	270-575-1007

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

Provider Enumeration Date	:	11/19/2008
Last Update Date	:	11/02/2017

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