Provider Demographics
NPI:1033892617
Name:LINDEMUTH, NINA (CRNP)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:LINDEMUTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 7TH AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-7002
Mailing Address - Country:US
Mailing Address - Phone:304-312-9683
Mailing Address - Fax:
Practice Address - Street 1:100 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3858
Practice Address - Country:US
Practice Address - Phone:814-299-7152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine