Provider Demographics
NPI:1528843935
Name:PETERSON, LINDSAY MICHELE (NP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MICHELE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:1150 STATE HIGHWAY 248 STE 202
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3729
Practice Address - Country:US
Practice Address - Phone:417-348-8964
Practice Address - Fax:417-336-0275
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2023032940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily