Provider Demographics
NPI:1154902955
Name:LINDIE, KELEN ALEXANDRIA
Entity type:Individual
Prefix:
First Name:KELEN
Middle Name:ALEXANDRIA
Last Name:LINDIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 ONSET LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3366
Mailing Address - Country:US
Mailing Address - Phone:240-579-6317
Mailing Address - Fax:
Practice Address - Street 1:1911 I ST NE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4146
Practice Address - Country:US
Practice Address - Phone:301-602-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant