Provider Demographics
NPI:1306281183
Name:NESMITH, LYNDSEY
Entity type:Individual
Prefix:MRS
First Name:LYNDSEY
Middle Name:
Last Name:NESMITH
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 294
Mailing Address - Street 2:
Mailing Address - City:SIPSEY
Mailing Address - State:AL
Mailing Address - Zip Code:35584-0294
Mailing Address - Country:US
Mailing Address - Phone:205-522-2039
Mailing Address - Fax:
Practice Address - Street 1:800 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0294
Practice Address - Country:US
Practice Address - Phone:205-522-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10631390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program