Provider Demographics
NPI:1043419450
Name:LOCKEN, LINDSEY K (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:K
Last Name:LOCKEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 SILVER LAKE RD NW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6324
Mailing Address - Country:US
Mailing Address - Phone:612-706-4500
Mailing Address - Fax:612-781-6830
Practice Address - Street 1:1151 SILVER LAKE RD NW
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6324
Practice Address - Country:US
Practice Address - Phone:612-706-4500
Practice Address - Fax:612-781-6830
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0370363A00000X
MN10296363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant