Provider Demographics
NPI:1154403327
Name:LINDGREN, AMY L (PNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT STREET
Mailing Address - Street 2:SOUTH 2 ROOM 236
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-241-6228
Mailing Address - Fax:515-241-8685
Practice Address - Street 1:1212 PLEASANT ST STE 300
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:515-241-8923
Practice Address - Fax:515-241-6497
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572623363LP0200X
IAC086176363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0439654Medicaid
MN1207890OtherMEDICA-PRIMARY
MN719824800Medicaid
MN1200206OtherMEDICA-CHOICE
MN1015964OtherPREFERRED ONE
MN768229OtherARAZ
MN116787OtherUCARE
MN157479OtherFAIRVIEW
MN45A42LIOtherBCBS
MNHP31992OtherHEALTH PARTNERS
MN157479OtherFAIRVIEW