Provider Demographics
NPI:1962657510
Name:LINDAHL, SAMANTHA
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LINDAHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:LINDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 E NORFOLK AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5323
Mailing Address - Country:US
Mailing Address - Phone:402-370-4204
Mailing Address - Fax:402-370-4206
Practice Address - Street 1:123 N 4TH ST
Practice Address - Street 2:SUITE 9
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4068
Practice Address - Country:US
Practice Address - Phone:402-370-4204
Practice Address - Fax:402-370-4206
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator