Provider Demographics
NPI:1487987897
Name:STREIT, LINDSAY RAE (FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:RAE
Last Name:STREIT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 WILBARGER ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-3137
Mailing Address - Country:US
Mailing Address - Phone:940-553-2140
Mailing Address - Fax:940-553-1739
Practice Address - Street 1:4103 WILBARGER ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-3137
Practice Address - Country:US
Practice Address - Phone:940-553-2140
Practice Address - Fax:940-553-1739
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX721249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210448101Medicaid
TX210448102Medicaid