Provider Demographics
NPI:1972268217
Name:LINDBERG, FELICIA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:MARIE
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 COLUMBINE LN
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-1276
Mailing Address - Country:US
Mailing Address - Phone:612-998-4622
Mailing Address - Fax:
Practice Address - Street 1:5225 COLUMBINE LN
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1276
Practice Address - Country:US
Practice Address - Phone:612-998-4622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO363A00000X
MN14864363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical