Provider Demographics
NPI:1245126507
Name:DUBBELDE, LINDA JEAN (CRNA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:DUBBELDE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:JEAN
Other - Last Name:DUBBELDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:2716 E SUNBURST DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-6715
Mailing Address - Country:US
Mailing Address - Phone:605-929-6065
Mailing Address - Fax:
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0401
Practice Address - Country:US
Practice Address - Phone:605-333-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCR001215367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered