Provider Demographics
NPI:1548458227
Name:THOMAS, LINDSAY P (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 MOUNTAIN TRCE NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4096
Mailing Address - Country:US
Mailing Address - Phone:615-830-6624
Mailing Address - Fax:
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8200
Practice Address - Country:US
Practice Address - Phone:678-265-8361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000157340163W00000X
TNAPN0000013176363LP0808X
GARN252769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33415641OtherMEDICARE PTAN
TN3341564OtherMEDICARE PTAN