Provider Demographics
NPI:1477849222
Name:ANDERSON, LINDSAY MARIE (PMHCNS-BC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 LEXINGTON PKWY N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4636
Mailing Address - Country:US
Mailing Address - Phone:651-280-2310
Mailing Address - Fax:651-280-2995
Practice Address - Street 1:451 LEXINGTON PKWY N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4636
Practice Address - Country:US
Practice Address - Phone:651-280-2310
Practice Address - Fax:651-280-2995
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-168717-6364SP0807X
MNCNS 0344364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent