Provider Demographics
NPI: | 1306806484 |
---|---|
Name: | LINDQUIST, CHRISTINE L (CRNA) |
Entity type: | Individual |
Prefix: | |
First Name: | CHRISTINE |
Middle Name: | L |
Last Name: | LINDQUIST |
Suffix: | |
Gender: | F |
Credentials: | CRNA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2920 N CASCADE AVE STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLORADO SPRINGS |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80907-6262 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 719-636-1201 |
Mailing Address - Fax: | 719-636-1326 |
Practice Address - Street 1: | 2920 N CASCADE AVE STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | COLORADO SPRINGS |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80907-6262 |
Practice Address - Country: | US |
Practice Address - Phone: | 719-636-1201 |
Practice Address - Fax: | 719-636-1326 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-03-24 |
Last Update Date: | 2024-12-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | APN.1000021-CRNA | 367500000X |
MN | R 101041-3 | 367500000X |
NM | CRNA-01270 | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
430005336 | Medicare ID - Type Unspecified |