Provider Demographics
NPI:1386915619
Name:SMITH-DUNFORD, LINDSEY MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:SMITH-DUNFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:YPS-CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:1305 WONDER WORLD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7546
Practice Address - Country:US
Practice Address - Phone:512-353-8161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731655367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296457901Medicaid