Provider Demographics
NPI:1912276429
Name:LINDBERG, PAULA JUDITH (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JUDITH
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 STATE ROUTE 20
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NY
Mailing Address - Zip Code:13402-9774
Mailing Address - Country:US
Mailing Address - Phone:315-893-1878
Mailing Address - Fax:315-893-7111
Practice Address - Street 1:7303 STATE ROUTE 20
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NY
Practice Address - Zip Code:13402-9774
Practice Address - Country:US
Practice Address - Phone:315-893-1878
Practice Address - Fax:315-893-7111
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263375163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool