Provider Demographics
NPI:1447584743
Name:SPEER, LINDSAY (CNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SPEER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:BROMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:605-328-6512
Practice Address - Street 1:3401 W 49TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2322
Practice Address - Country:US
Practice Address - Phone:605-328-1850
Practice Address - Fax:605-328-1855
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS103642Medicare PIN