MEDICARE: DR. LAURA ANN LINDHOLM MD

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
1	207V00000X	Obstetrics & Gynecology Physician	30396	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1720074040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ANN LINDHOLM MD

Provider Business Mailing Address
First Line	:	1225 CIMARRON DR
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-3812
Country	:	US
Telephone Number	:	720-204-1870
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 CIMARRON DR
Second Line	:	SUITE 101
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-3812
Country	:	US
Telephone Number	:	720-204-1870
Fax Number	:	720-438-7844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	11/11/2015

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