Provider Demographics
NPI:1659309888
Name:LINDSTROM, ANDREA (CNM)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LINDSTROM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3348
Mailing Address - Country:US
Mailing Address - Phone:732-914-1919
Mailing Address - Fax:732-341-3303
Practice Address - Street 1:222 OAK AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3348
Practice Address - Country:US
Practice Address - Phone:732-914-1919
Practice Address - Fax:732-341-3303
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00031500176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife