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NPI Code Detail

MEDICARE: LINDSEY ELISE GRISWOLD PA-C

MEDICARE: LINDSEY ELISE GRISWOLD PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant107413IA

General Provider Information

NPI Number : 1053996389
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY ELISE GRISWOLD PA-C
Provider Business Mailing Address
First Line : 1900 SILVER LAKE RD NW STE 110
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-1789
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7545 ASHWORTH RD STE 210
Second Line :
City : WEST DES MOINES
State : IA
Zip : 50266-5954
Country : US
Telephone Number : 515-854-3618
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2021
Last Update Date : 02/21/2025

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Directions to “ LINDSEY ELISE GRISWOLD PA-C” Practice Location

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