Provider Demographics
NPI:1891520896
Name:LEVESQUE, LINDSAY GENTRY STEGEMAN (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:GENTRY STEGEMAN
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:GENTRY
Other - Last Name:STEGEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1441 N TRACY BLVD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3445
Practice Address - Country:US
Practice Address - Phone:877-855-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236465367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife