1356635627 NPI number — MRS. LYNDSEY NYKIEL STUERMAN ANP

Table of content: MRS. LYNDSEY NYKIEL STUERMAN ANP (NPI 1356635627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356635627 NPI number — MRS. LYNDSEY NYKIEL STUERMAN ANP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STUERMAN
Provider First Name:
LYNDSEY
Provider Middle Name:
NYKIEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ANP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NYKIEL
Provider Other First Name:
LYNDSEY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ANP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356635627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRASER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80442-2127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-485-0266
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 SOUTH 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KREMMLING
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80459-0399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-724-3442
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2011

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: 363LA2200X , with the licence number:  APN0010282-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LA2200X , with the licence number: 53-75121-021 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: A1009239 . This is a "AMERICAN ACADEMY OF NURSE PRACTITIONERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: APN-0010282-NP . This is a "ADVANCED PRACTICE LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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