Basic Information
| Provider Information | |||||||||
| NPI: | 1306805528 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINDSAY | ||||||||
| FirstName: | VICKY | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 608 | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461730608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659327591 | ||||||||
| FaxNumber: | 7659327505 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 E 13TH ST | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461732126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659327591 | ||||||||
| FaxNumber: | 7659327505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2006 | ||||||||
| LastUpdateDate: | 08/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 71000972B | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 200456670 | 05 | IN | MEDICAID | 000000510967 | 01 | IN | ANTHEM BCBS | OTHER |