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General NPI Number Information
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NPI Number | 1144642893
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Entity Type | Individual
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Provider Name | KATHRYN LINDSTROM FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 435 PHALEN BLVD
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City | SAINT PAUL
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State | MN
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Zip | 55130-5302
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Country | US
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Telephone | 651-325-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 435 PHALEN BLVD
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City | SAINT PAUL
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State | MN
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Zip | 55130-5302
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Country | US
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Telephone | 651-325-2253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R153973-2
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 40319
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN-70309
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 176021
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License Number State | WI
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