Provider Demographics
NPI:1275378762
Name:LATIERRA LINDSEY NP, LLC
Entity type:Organization
Organization Name:LATIERRA LINDSEY NP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LATIERRA
Authorized Official - Middle Name:DESIRAE
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:913-404-6043
Mailing Address - Street 1:12400 W 62ND TER STE C
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-1898
Mailing Address - Country:US
Mailing Address - Phone:913-404-6043
Mailing Address - Fax:
Practice Address - Street 1:12400 W 62ND TER STE C
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-1898
Practice Address - Country:US
Practice Address - Phone:913-404-6043
Practice Address - Fax:913-222-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty