Lindsay Rebecca Shackelford, LPN

Individual provider Active NPI Licensed Practical Nurse · Oliver Springs, TN

NPI 1497599989 · NPPES record last updated Jun 20, 2024

Key facts

NPI
1497599989
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
83974 (TN)
Practice address
810 E Tri County Blvd
Oliver Springs, TN 37840-1828
Phone
(865) 466-6522
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
83974TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 83974 TN Yes

Addresses

Primary practice location

810 E Tri County Blvd
Oliver Springs, TN 37840-1828

Mailing address

810 E Tri County Blvd
Oliver Springs, TN 37840-1828
Phone (865) 466-6522

Other providers in Oliver Springs, TN

All providers in Oliver Springs, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.