Provider Demographics
NPI:1245954478
Name:CARPENTER, LINDSAY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6019 LEMHI ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-8064
Mailing Address - Country:US
Mailing Address - Phone:480-452-4755
Mailing Address - Fax:
Practice Address - Street 1:6019 LEMHI ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-8064
Practice Address - Country:US
Practice Address - Phone:480-452-4755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL-99591163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty