Provider Demographics
NPI:1427829951
Name:ANTES, LINDSAY (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:ANTES
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 LAURA ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1712
Mailing Address - Country:US
Mailing Address - Phone:816-315-6540
Mailing Address - Fax:
Practice Address - Street 1:207 LAURA ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1712
Practice Address - Country:US
Practice Address - Phone:816-315-6540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019008265163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant