Individual
LINDSEY FLACCOMIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
002725
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
877440
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04752851
—
MS
Enumeration date
01/05/2012
Last updated
08/11/2020
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