Individual
LINDSEY LEE HENDERSON DREVECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1040 TACOMA AVE, BISMARCK, ND 58504-7452
(701) 323-8961
Mailing address
1040 TACOMA AVE, BISMARCK, ND 58504-7452
(701) 323-8961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14215
ND
207Q00000X
Family Medicine Physician
4301103265
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301103265
MI
Other
Enumeration date
06/18/2013
Last updated
10/24/2016
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