Provider Demographics
NPI:1528218302
Name:LINDENFELSER, JUDITH MATHILDA
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MATHILDA
Last Name:LINDENFELSER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:MATHILDA
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:16635 CENTERFIELD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7719
Mailing Address - Country:US
Mailing Address - Phone:907-694-0493
Mailing Address - Fax:907-694-0933
Practice Address - Street 1:16635 CENTERFIELD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7719
Practice Address - Country:US
Practice Address - Phone:907-694-0493
Practice Address - Fax:907-694-0933
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK338364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult