Basic Information
Provider Information
NPI: 1356708408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIGHTNER
FirstName: LINDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3324 FRENCH PARK DR
Address2: SUITE D
City: EDMOND
State: OK
PostalCode: 730347269
CountryCode: US
TelephoneNumber: 4057153610
FaxNumber: 4057153612
Practice Location
Address1: 9600 BROADWAY EXT
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731147408
CountryCode: US
TelephoneNumber: 4052309200
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2016
LastUpdateDate: 01/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X97188OKY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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