1962717728 NPI number — DR. LINDSEY HAMMOND TEIGLAND PH.D.

Table of content: DR. LINDSEY HAMMOND TEIGLAND PH.D. (NPI 1962717728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962717728 NPI number — DR. LINDSEY HAMMOND TEIGLAND PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEIGLAND
Provider First Name:
LINDSEY
Provider Middle Name:
HAMMOND
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAMMOND
Provider Other First Name:
LINDSEY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962717728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4174 SUMMERBROOKE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55123-2361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-484-0268
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2302 WYCLIFF STREET
Provider Second Line Business Practice Location Address:
SUITE 319
Provider Business Practice Location Address City Name:
ST. PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-484-0268
Provider Business Practice Location Address Fax Number:
952-942-5627
Provider Enumeration Date:
08/17/2010

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: 103T00000X , with the licence number:  LP5079 , 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)





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