Individual provider Active NPI

Stephanie Anne Lundblad, APRN, CNP

  • Family Nurse Practitioner
  • Keene, NH
National Provider Identifier
1215306154
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111997-23 Issued in NH
Practice address
580 Court St
Keene, NH 03431-1718
Phone
(603) 354-5400
NPI assigned
Sep 22, 2015
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP3948 MN
Family Nurse Practitioner 363LF0000X 111997-23 NH Primary

Addresses

Primary practice location

580 Court St
Keene, NH 03431-1718

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 722-8634

Other practice location 1

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113001382 NH Practitioner - Nurse Practitioner 4385922194 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 8, 2025 Accepting new patients
Cheshire Medical Center Current Accepting new patients
Cheshire Medical Center CurrentSince Jan 8, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 8, 2025 Accepting new patients

Locations

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: slundblad625828@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1215306154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-722-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311718",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDBLAD",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP3948",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "111997-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.