Provider Demographics
NPI:1316242522
Name:DELHOMMER, LINDSEY BOLT (CRNA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BOLT
Last Name:DELHOMMER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-214-6436
Mailing Address - Fax:225-214-6437
Practice Address - Street 1:7777 HENNESSY BLVD.
Practice Address - Street 2:SUITE 301
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-214-6436
Practice Address - Fax:225-214-6437
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS883849367500000X
LAAP06469367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I430117Medicare PIN