Basic Information
Provider Information
NPI: 1184260184
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DENION
FirstName: LINDSAY
MiddleName: THERESA
NamePrefix: MS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 178224903
CountryCode: US
TelephoneNumber: 5702716144
FaxNumber: 5702716578
Practice Location
Address1: 114 LT MICHAEL CLEARY DR
Address2:  
City: DALLAS
State: PA
PostalCode: 186121649
CountryCode: US
TelephoneNumber: 5706752000
FaxNumber: 5706751806
Other Information
ProviderEnumerationDate: 11/25/2019
LastUpdateDate: 08/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMA061247PAN Allopathic & Osteopathic PhysiciansFamily Medicine 
363A00000XMA061247PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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