Healthcare Provider Details

I. General information

NPI: 1457794943
Provider Name (Legal Business Name): LYNN MARIE GEVIK APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 04/12/2025
Certification Date: 04/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 METRO BLVD STE 550
EDINA MN
55439-1353
US

IV. Provider business mailing address

4121 GLADSTONE ST
DULUTH MN
55804-1955
US

V. Phone/Fax

Practice location:
  • Phone: 218-606-3186
  • Fax: --
Mailing address:
  • Phone: 218-591-3604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number136574-4
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number119767-30
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7627-33
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP2482
License Number StateMN
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP2482
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: