1346572856 NPI number — LINDSAY DIANE WILBANKS CNM

Table of content: LINDSAY DIANE WILBANKS CNM (NPI 1346572856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346572856 NPI number — LINDSAY DIANE WILBANKS CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILBANKS
Provider First Name:
LINDSAY
Provider Middle Name:
DIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346572856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EVANS ARMY COMMUNITY HOSPITAL
Provider Second Line Business Mailing Address:
1650 COCHRANE CIRCLE B7500
Provider Business Mailing Address City Name:
FT. CARSON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-524-2164
Provider Business Mailing Address Fax Number:
719-526-7850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 COCHRANE CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-4613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-524-2164
Provider Business Practice Location Address Fax Number:
719-526-7850
Provider Enumeration Date:
02/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  AP60138928 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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