Provider Demographics
NPI:1902572852
Name:OKOWITA, LINDSAY MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MICHELLE
Last Name:OKOWITA
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:109 ORCHARD HILL CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18226 VENTURA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4246
Practice Address - Country:US
Practice Address - Phone:818-905-5904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-09-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant