Healthcare Provider Details
I. General information
NPI: 1821908138
Provider Name (Legal Business Name): EVELYN CAMILLE LINDEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2305 37TH AVE SW
MINOT ND
58701-7669
US
IV. Provider business mailing address
4886 OCCOQUAN CLUB DR
WOODBRIDGE VA
22192-5906
US
V. Phone/Fax
- Phone: 701-418-8000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 2305217916 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: