Provider Demographics
NPI:1588878227
Name:LUNDIN, ELSE-MARIE A (NP)
Entity type:Individual
Prefix:
First Name:ELSE-MARIE
Middle Name:A
Last Name:LUNDIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MIA
Other - Middle Name:ELSE-MARIE
Other - Last Name:LUNDIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 E ARRELLAGA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2274
Mailing Address - Country:US
Mailing Address - Phone:805-882-1956
Mailing Address - Fax:805-882-1821
Practice Address - Street 1:601 E ARRELLAGA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2274
Practice Address - Country:US
Practice Address - Phone:805-882-1956
Practice Address - Fax:805-882-1821
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 5341363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health