Provider Demographics
NPI:1194063503
Name:LINDGREN, SHEILA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HWY 2 W
Mailing Address - Street 2:LAKE REGION HUMAN SERVICE CENTER
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-0650
Mailing Address - Country:US
Mailing Address - Phone:701-665-2200
Mailing Address - Fax:701-665-2300
Practice Address - Street 1:200 HWY 2 W
Practice Address - Street 2:LAKE REGION HUMAN SERVICE CENTER
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-0650
Practice Address - Country:US
Practice Address - Phone:701-665-2200
Practice Address - Fax:701-665-2300
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0512363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant