Provider Demographics
NPI:1366151615
Name:DEVAADITHIYA-APPUHAMY, LINDAMULAGE SUPUN DINITHI CHANDR (DNP, PMHNP-BC, CNP)
Entity type:Individual
Prefix:DR
First Name:LINDAMULAGE
Middle Name:SUPUN DINITHI CHANDR
Last Name:DEVAADITHIYA-APPUHAMY
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, CNP
Other - Prefix:
Other - First Name:LINDAMULAGE
Other - Middle Name:SUPUN DINITHI CHANDR
Other - Last Name:DEVAADITHIYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:
Practice Address - Street 1:1705 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6151
Practice Address - Country:US
Practice Address - Phone:218-333-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9814363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health