Provider Demographics
NPI:1912760521
Name:LINDSAY, ANGELA D (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:YESUVIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:27427 PARAMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9774
Mailing Address - Country:US
Mailing Address - Phone:907-982-0150
Mailing Address - Fax:
Practice Address - Street 1:245 N BINKLEY ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7500
Practice Address - Country:US
Practice Address - Phone:452-190-7714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKRADACT101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty