Provider Demographics
NPI:1093449704
Name:SIEGRIST, LINDA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:SIEGRIST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 BLUE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5023
Mailing Address - Country:US
Mailing Address - Phone:914-443-7430
Mailing Address - Fax:
Practice Address - Street 1:1525 BLUE SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2004
Practice Address - Country:US
Practice Address - Phone:970-498-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1654339163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse