Provider Demographics
NPI:1528674959
Name:ROSS, LINDSEY CAROL (DNP FNP-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:CAROL
Last Name:ROSS
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-5237
Mailing Address - Country:US
Mailing Address - Phone:217-808-2101
Mailing Address - Fax:
Practice Address - Street 1:802 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-5237
Practice Address - Country:US
Practice Address - Phone:217-808-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily