Provider Demographics
NPI:1871949503
Name:MCNUTT, LINDSEY (CRNA)
Entity type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:
Last Name:MCNUTT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:K
Other - Last Name:ERVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:851 TRAFALGAR CT
Mailing Address - Street 2:SUITE 200E
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4132
Mailing Address - Country:US
Mailing Address - Phone:321-422-7155
Mailing Address - Fax:407-667-4338
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1248
Practice Address - Country:US
Practice Address - Phone:352-273-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9314543367500000X
FLARNP9314543367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid
FL017720800Medicaid
FLPENDINGOtherBCBS