Provider Demographics
NPI:1255979761
Name:L L NURSE PRACTITIONER CONSUTLING LLC LL AESTHETHICS LLC
Entity type:Organization
Organization Name:L L NURSE PRACTITIONER CONSUTLING LLC LL AESTHETHICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-852-5993
Mailing Address - Street 1:18422 DAKOTA RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-5618
Mailing Address - Country:US
Mailing Address - Phone:813-852-5993
Mailing Address - Fax:877-991-7191
Practice Address - Street 1:165 SW VISION GLN
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-1111
Practice Address - Country:US
Practice Address - Phone:813-852-5993
Practice Address - Fax:877-991-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty