Provider Demographics
NPI:1053624809
Name:HOUSE, LINDSAY NICOLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:NICOLE
Last Name:HOUSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10060 DEMIA WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4734
Mailing Address - Country:US
Mailing Address - Phone:859-525-6770
Mailing Address - Fax:
Practice Address - Street 1:10060 DEMIA WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4734
Practice Address - Country:US
Practice Address - Phone:859-525-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY654OP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily