Healthcare Provider Details

I. General information

NPI: 1841673902
Provider Name (Legal Business Name): NICHOLAS LINDERER CRNA, DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 DELHI ST STE 300
DUBUQUE IA
52001-6320
US

IV. Provider business mailing address

1132 LOCUST ST APT B1
DUBUQUE IA
52001-4782
US

V. Phone/Fax

Practice location:
  • Phone: 563-557-5991
  • Fax:
Mailing address:
  • Phone: 913-787-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number139869
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: