Basic Information
Provider Information
NPI: 1336449990
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCBURNEY
FirstName: LINDSAY
MiddleName: K
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1185 W MARKET PLACE
Address2: SUITE P
City: FULTON
State: MD
PostalCode: 20759
CountryCode: US
TelephoneNumber: 3013408339
FaxNumber: 2404855407
Practice Location
Address1: 1165 IMPERIAL DR
Address2: SUITE 300
City: HAGERSTOWN
State: MD
PostalCode: 217406555
CountryCode: US
TelephoneNumber: 3016659098
FaxNumber: 3016659096
Other Information
ProviderEnumerationDate: 10/29/2010
LastUpdateDate: 03/02/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XC004379MDY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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