Healthcare Provider Details

I. General information

NPI: 1710890975
Provider Name (Legal Business Name): EVAN D LINDAU RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E 2ND ST
DULUTH MN
55805-1906
US

IV. Provider business mailing address

1225 N 23RD ST
SUPERIOR WI
54880-5011
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2500676
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: