Provider Demographics
NPI:1316964810
Name:LINDSEY, TERIANNE (PNP)
Entity type:Individual
Prefix:MS
First Name:TERIANNE
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:MSC 8515-87-1200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-2468
Mailing Address - Fax:314-454-2524
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED ADOLESCENT MEDICINE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2468
Practice Address - Fax:314-454-2524
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO098387363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO427196803Medicaid
MO427196803Medicaid
IL$$$$$$$$$001Medicaid
MO103810187Medicare PIN