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NPI Code Detail

MEDICARE: LORI ANN EDLUND CNP

MEDICARE: LORI ANN EDLUND CNP
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
1363LF0000XFamily Nurse PractitionerR-145217-8MN

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 : 1821388372
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN EDLUND CNP
Provider Business Mailing Address
First Line : 251 COUNTY ROAD 120
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-4872
Country : US
Telephone Number : 320-202-8949
Fax Number :
Provider Business Practice Location Address
First Line : 402 RED RIVER AVE N
Second Line :
City : COLD SPRING
State : MN
Zip : 56320-1521
Country : US
Telephone Number : 320-685-8641
Fax Number : 320-685-4020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2011
Last Update Date : 02/21/2014

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