Basic Information
| Provider Information | |||||||||
| NPI: | 1053046003 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINDO | ||||||||
| FirstName: | KEMONE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4644 ERSKINE ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794162400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083459287 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8602 PEACH AVE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794047777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067451021 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2022 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 2021210396 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.