Healthcare Provider Details

I. General information

NPI: 1841502317
Provider Name (Legal Business Name): LINDSEY MICHELLE-PATEE DEEB PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 CARMEN AVE
INVER GROVE HEIGHTS MN
55076-4416
US

IV. Provider business mailing address

5975 CARMEN AVE
INVER GROVE HEIGHTS MN
55076-4416
US

V. Phone/Fax

Practice location:
  • Phone: 651-455-9697
  • Fax: 651-455-2012
Mailing address:
  • Phone: 651-455-9697
  • Fax: 651-455-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR 169355-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: