Provider Demographics
NPI:1215022884
Name:LINDSLEY, TRACY L (CRNA)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:L
Last Name:LINDSLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:L
Other - Last Name:DUFFETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P O BOX 2726
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202
Mailing Address - Country:US
Mailing Address - Phone:888-245-5525
Mailing Address - Fax:717-653-8197
Practice Address - Street 1:50 MEDICAL PARK EAST DRIVE
Practice Address - Street 2:
Practice Address - City:BIRMNGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-838-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-081845367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51534856OtherBLUE SHIELD
AL051534856Medicare PIN