Provider Demographics
NPI:1568952737
Name:LINDQUIST, SHANNON KAY
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:KAY
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W UPTON AVE
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-1149
Mailing Address - Country:US
Mailing Address - Phone:231-832-6139
Mailing Address - Fax:231-832-3381
Practice Address - Street 1:301 W UPTON AVE
Practice Address - Street 2:
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-1149
Practice Address - Country:US
Practice Address - Phone:231-832-6139
Practice Address - Fax:231-832-3381
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator