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NPI Code Detail

MEDICARE: MRS. LYNN THERESE SPINDLER- EBENSPERGER PA-C MMS

MEDICARE: MRS. LYNN THERESE SPINDLER- EBENSPERGER PA-C MMS
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 Assistant1110-023WI
2363A00000XPhysician Assistant12507MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467480061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN THERESE SPINDLER- EBENSPERGER PA-C MMS
Provider Business Mailing Address
First Line : 815 2ND ST
Second Line :
City : PEPIN
State : WI
Zip : 54759-9662
Country : US
Telephone Number : 715-495-6385
Fax Number :
Provider Business Practice Location Address
First Line : 16490 W 78TH ST
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55346-4300
Country : US
Telephone Number : 715-495-6385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 03/17/2018

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