Provider Demographics
NPI:1194075077
Name:MARTIN, LINDSEY JEANETTE
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JEANETTE
Last Name:MARTIN
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:PO BOX 4385
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:KY
Mailing Address - Zip Code:40347-4385
Mailing Address - Country:US
Mailing Address - Phone:606-627-3995
Mailing Address - Fax:
Practice Address - Street 1:343 WALLER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2912
Practice Address - Country:US
Practice Address - Phone:859-271-9448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator