Individual
DOMINIC LINDEQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
677 NEWBURY ST, CARMEL, IN 46032-6043
(414) 241-6954
Mailing address
677 NEWBURY ST, CARMEL, IN 46032-6043
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
COA 11300-NP
OH
363LF0000X
Family Nurse Practitioner
11300-NP
OH
363LF0000X
Family Nurse Practitioner
Primary
71004045A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201100500
—
IN
05
—
3047849
—
OH
01
—
P01424374
MEDICARE RAILROAD PTAN
IN
Enumeration date
01/25/2010
Last updated
09/06/2017
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