1033200035 NPI number — MS. BARBARA ANN LIND L.I.S.W.

Table of content: SHANNON LEE CARROLL (NPI 1407651714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033200035 NPI number — MS. BARBARA ANN LIND L.I.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIND
Provider First Name:
BARBARA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.I.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033200035
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1649 N 23RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT DODGE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50501-7913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-277-7218
Provider Business Mailing Address Fax Number:
888-501-1525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1605 1ST AVE N
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
FORT DODGE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50501-4238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-277-7218
Provider Business Practice Location Address Fax Number:
888-501-1525
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  06432 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)