Provider Demographics
NPI:1215159140
Name:LINDSEY, CAROLYN J
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:J
Last Name:LINDSEY
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 1:3851 DURANGO GREEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-1388
Mailing Address - Country:US
Mailing Address - Phone:513-467-9388
Mailing Address - Fax:
Practice Address - Street 1:3851 DURANGO GREEN DRIVE
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-1388
Practice Address - Country:US
Practice Address - Phone:513-467-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH209598163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0850039Medicaid