Provider Demographics
NPI:1407133671
Name:LINDQUIST, AMY LYNNE (CPHT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5136 EAGLE DR # 1045
Mailing Address - Street 2:
Mailing Address - City:UNITED STATES AIR FORCE ACAD
Mailing Address - State:CO
Mailing Address - Zip Code:80840-2607
Mailing Address - Country:US
Mailing Address - Phone:719-333-0540
Mailing Address - Fax:
Practice Address - Street 1:5136 EAGLE DR # 1045
Practice Address - Street 2:
Practice Address - City:UNITED STATES AIR FORCE ACAD
Practice Address - State:CO
Practice Address - Zip Code:80840-2607
Practice Address - Country:US
Practice Address - Phone:719-333-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHAT.001520183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician