Provider Demographics
NPI:1265884175
Name:LINDSEY, JESSIE (NP-C)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 SEAMAN RD
Mailing Address - Street 2:
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-9286
Mailing Address - Country:US
Mailing Address - Phone:770-356-0116
Mailing Address - Fax:
Practice Address - Street 1:1018 COWAN RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3404
Practice Address - Country:US
Practice Address - Phone:228-265-7945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215593363LF0000X
MS903320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily