Provider Demographics
NPI:1366957045
Name:CALVERT, LINDSAY SUZANNE
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:SUZANNE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 SAINT PHILIP RD S
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-8657
Mailing Address - Country:US
Mailing Address - Phone:812-204-5974
Mailing Address - Fax:
Practice Address - Street 1:1824 SAINT PHILIP RD S
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-8657
Practice Address - Country:US
Practice Address - Phone:812-204-5974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer