1740434992 NPI number — KRISTIN AMBER LINDER-BROWN OTR/L

Table of content: KRISTIN AMBER LINDER-BROWN OTR/L (NPI 1740434992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740434992 NPI number — KRISTIN AMBER LINDER-BROWN OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINDER-BROWN
Provider First Name:
KRISTIN
Provider Middle Name:
AMBER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
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:
1740434992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5842 HOBE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE BEAR LAKE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55110-6477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-603-8774
Provider Business Mailing Address Fax Number:
605-603-9009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6113 3RD AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55419-2508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-235-1245
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2008

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: 225X00000X , with the licence number:  102686 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com