Healthcare Provider Details

I. General information

NPI: 1902057615
Provider Name (Legal Business Name): LINDA LOU ELLINGHUYSEN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 GARVIN HEIGHTS RD
WINONA MN
55987-5425
US

IV. Provider business mailing address

1855 GARVIN HEIGHTS RD
WINONA MN
55987-5425
US

V. Phone/Fax

Practice location:
  • Phone: 608-372-3971
  • Fax: 608-372-1689
Mailing address:
  • Phone: 608-372-3971
  • Fax: 608-372-1689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number88328-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: