Healthcare Provider Details

I. General information

NPI: 1457569436
Provider Name (Legal Business Name): LINDA ANN PIPKORN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 35TH AVE S
MINNEAPOLIS MN
55406-2741
US

IV. Provider business mailing address

3450 35TH AVE S
MINNEAPOLIS MN
55406-2741
US

V. Phone/Fax

Practice location:
  • Phone: 612-729-2179
  • Fax:
Mailing address:
  • Phone: 612-729-2179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number100301
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: