Healthcare Provider Details

I. General information

NPI: 1770682346
Provider Name (Legal Business Name): DANA LINDGREN SHOUP N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E JEFFERSON ST STE 1
CHARLOTTESVILLE VA
22902-5353
US

IV. Provider business mailing address

1101 E JEFFERSON ST STE 1
CHARLOTTESVILLE VA
22902-5353
US

V. Phone/Fax

Practice location:
  • Phone: 434-227-5624
  • Fax: 434-977-7700
Mailing address:
  • Phone: 434-227-5624
  • Fax: 434-970-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024164311
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: