Healthcare Provider Details

I. General information

NPI: 1629420070
Provider Name (Legal Business Name): LINDSEY ANN DAHM APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 BEAM AVE
MAPLEWOOD MN
55109-1126
US

IV. Provider business mailing address

5600 CAMERATA WAY UNIT 230
SAINT LOUIS PARK MN
55416-5285
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-7000
  • Fax:
Mailing address:
  • Phone: 608-345-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP 4508
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: