Provider Demographics
NPI:1982651725
Name:HOERAUF, LYNDA B (NP)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:B
Last Name:HOERAUF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3995 COUNTY ROAD 89
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:ND
Mailing Address - Zip Code:58638-9381
Mailing Address - Country:US
Mailing Address - Phone:701-878-4228
Mailing Address - Fax:
Practice Address - Street 1:811 MAIN AVE
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:ND
Practice Address - Zip Code:58638-7057
Practice Address - Country:US
Practice Address - Phone:701-878-4250
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR15270363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND23777OtherBCBS - ELGIN
ND23446OtherBCBS - HEBRON CLINIC
ND19631Medicaid
ND19631Medicaid
NDS00910Medicare UPIN