Provider Demographics
NPI:1316420292
Name:WELLMAN, LINDSAY (RN)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 FURNAS ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1219
Mailing Address - Country:US
Mailing Address - Phone:403-658-5764
Mailing Address - Fax:
Practice Address - Street 1:1842 FURNAS ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1219
Practice Address - Country:US
Practice Address - Phone:403-658-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE68587163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE68587Medicaid