Provider Demographics
NPI:1457622599
Name:LINDEBURG, EDITH (RN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:
Last Name:LINDEBURG
Suffix:
Gender:F
Credentials:RN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1235
Mailing Address - Country:US
Mailing Address - Phone:303-839-7690
Mailing Address - Fax:303-839-7694
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1235
Practice Address - Country:US
Practice Address - Phone:303-839-7690
Practice Address - Fax:303-839-7694
Is Sole Proprietor?:No
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO97267363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care