Basic Information
| Provider Information | |||||||||
| NPI: | 1700838497 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PETTIT | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | C.N.M., R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 WHIPPLE AVE | ||||||||
| Address2: | #135 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503665594 | ||||||||
| FaxNumber: | 6503666352 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 WHIPPLE AVE | ||||||||
| Address2: | #135 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503665594 | ||||||||
| FaxNumber: | 6503666352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 07/13/2016 | ||||||||
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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 | 174400000X | 4948 | CA | N | Other Service Providers | Specialist | 367A00000X | 218 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 812 | 01 | CA | NURSE MIDWIFE CERT # | OTHER | 4948 | 01 | CA | NP CERT # | OTHER | 336037 | 01 | CA | RN CERT # | OTHER |