Provider Demographics
NPI:1952126500
Name:SUNDLOFF, LINDSAY
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SUNDLOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4482 N 7 C LN
Mailing Address - Street 2:
Mailing Address - City:ERDA
Mailing Address - State:UT
Mailing Address - Zip Code:84074-7432
Mailing Address - Country:US
Mailing Address - Phone:435-241-0037
Mailing Address - Fax:
Practice Address - Street 1:4482 N 7 C LN
Practice Address - Street 2:
Practice Address - City:ERDA
Practice Address - State:UT
Practice Address - Zip Code:84074-7432
Practice Address - Country:US
Practice Address - Phone:435-241-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11762094-3103163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator