Healthcare Provider Details

I. General information

NPI: 1437571775
Provider Name (Legal Business Name): JAMIE LINDELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 SUNSET PL
NEILLSVILLE WI
54456-1706
US

IV. Provider business mailing address

216 SUNSET PL
NEILLSVILLE WI
54456-1706
US

V. Phone/Fax

Practice location:
  • Phone: 715-743-3101
  • Fax: 715-743-6242
Mailing address:
  • Phone: 715-743-3101
  • Fax: 715-743-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5521-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: