Connie Renee Lindberg

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

MA00020294 Issued in WA

Practice address

10611 Canyon Rd E # 167
Puyallup, WA 98373-4256

Phone

(253) 254-9093

NPI assigned

Jun 2, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Connie Renee Lindberg Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1104110568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983716300",
            "telephone_number": "253-446-6471",
            "fax_number": "253-446-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 CANYON RD E # 167",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734256",
            "telephone_number": "253-254-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBERG",
        "first_name": "CONNIE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "MA00020294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE PRACTITIONER LICENSE",
            "identifier": "#MA00020294",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "LINDBERG",
            "middle_name": "RENEE",
            "credential": ".LMP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Yeluma Lima Monica
• Shih Wei Lin, DMD
• Zhian Lin
• Laura Lind, ARNP
• Wendy R Lind, O.T.
• Jessica J Lindbo, LMP
• Jan Lindholm, LMHC, CDP, LRCP
• Alice T Lindsley, MA
• Amy Elizabeth M. Lineaweaver, M.S. CCC-SLP
• Joshua Lingbloom, LMP

• Community Health Worker in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.