Basic Information
Provider Information
NPI: 1912490707
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNETT
FirstName: LINDSAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 400
Address2:  
City: JACKSON
State: TN
PostalCode: 383020400
CountryCode: US
TelephoneNumber: 7314255752
FaxNumber: 7314225743
Practice Location
Address1: 20719 MAIN ST E
Address2:  
City: HUNTINGDON
State: TN
PostalCode: 383444235
CountryCode: US
TelephoneNumber: 7319862056
FaxNumber: 7319862352
Other Information
ProviderEnumerationDate: 06/07/2018
LastUpdateDate: 09/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X24165TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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