Provider Demographics
NPI:1992107932
Name:GARRETT, LINDIE ELAINE (NP)
Entity type:Individual
Prefix:MRS
First Name:LINDIE
Middle Name:ELAINE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2693 GUN AND ROD CLUB RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:DE
Mailing Address - Zip Code:19954-2636
Mailing Address - Country:US
Mailing Address - Phone:302-398-4829
Mailing Address - Fax:
Practice Address - Street 1:120 OLD CAMDEN RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-5523
Practice Address - Country:US
Practice Address - Phone:302-883-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0000293363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner