Provider Demographics
NPI:1992088348
Name:NELSON, LINDSEY LEIGH
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LEIGH
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:HAAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4100 HAMLINE AVE N
Mailing Address - Street 2:MAIL STOP 5-270
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-5700
Mailing Address - Country:US
Mailing Address - Phone:651-582-6911
Mailing Address - Fax:
Practice Address - Street 1:4100 HAMLINE AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-5700
Practice Address - Country:US
Practice Address - Phone:651-582-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN216394-5363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily