Basic Information
| Provider Information | |||||||||
| NPI: | 1477942365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YEAGER | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | LAT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7205 ESTERO BLVD UNIT 5 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339314786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399806235 | ||||||||
| FaxNumber: | 2393145119 | ||||||||
| Practice Location | |||||||||
| Address1: | 7205 ESTERO BLVD UNIT 5 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339314786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393145118 | ||||||||
| FaxNumber: | 2393145119 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2015 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT38114 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.