Healthcare Provider Details

I. General information

NPI: 1760648257
Provider Name (Legal Business Name): JUDITH ANN LINDEMANN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSPITAL RD 316
NEWPORT BEACH CA
92663-3509
US

IV. Provider business mailing address

351 HOSPITAL RD 316
NEWPORT BEACH CA
92663-3509
US

V. Phone/Fax

Practice location:
  • Phone: 949-642-5775
  • Fax: 949-642-2037
Mailing address:
  • Phone: 949-642-5775
  • Fax: 949-642-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN229048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: