Provider Demographics
NPI:1154190668
Name:NUXOLL, LINDSAY RAE (CNA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RAE
Last Name:NUXOLL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 83RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7601
Mailing Address - Country:US
Mailing Address - Phone:208-791-2561
Mailing Address - Fax:
Practice Address - Street 1:1441 83RD AVE SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7601
Practice Address - Country:US
Practice Address - Phone:208-791-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60766811376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide