Kristen Ann Lindblom, FNP
Individual provider Active NPI Nurse Practitioner · Duluth, MN
NPI 1972589034 · NPPES record last updated Jun 15, 2012
Key facts
- NPI
- 1972589034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 142804 (WI)
- Practice address
- 1420 London Rd Ste 210
Duluth, MN 55805-2422 - Phone
- (218) 728-6160
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080115000489 | MN | Practitioner - Nurse Practitioner | 2860573987 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142804 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healtheast Medical Research Institute | Current |
Accepting new patients | |
| Fairview Health Services | Current |
Accepting new patients | |
| Healtheast Medical Research Institute | Current |
Accepting new patients | |
| Fairview Clinics | Current |
Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Fairview Clinics | Current |
Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients |
Locations
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800
2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800
1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 142804 | WI | Yes |
Addresses
Primary practice location
1420 London Rd Ste 210
Duluth, MN 55805-2422
Mailing address
1420 London Rd Ste 210
Duluth, MN 55805-2422
Phone (218) 728-6160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43980400 | Medicaid | WI | |
| 419715100 | Other | MN | MA |
Other providers in Duluth, MN
- Kate Lin
- Pamela Elizabeth Lincoln
- Isabella M Lind
- Todd S Lind
- Amelie Joann Lindberg-Livingston
- Marjorie Anne Lindemann
- Karen Lindgren
- Lori G W Lindgren
- Jordan R Lindholm
- Kristina Marie Lindholm
All providers in Duluth, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.