Provider Demographics
NPI:1134264161
Name:PIOTTER, LYNNEA H (PNP)
Entity type:Individual
Prefix:
First Name:LYNNEA
Middle Name:H
Last Name:PIOTTER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17705 HUTCHINS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4102
Mailing Address - Country:US
Mailing Address - Phone:952-401-8300
Mailing Address - Fax:952-401-8246
Practice Address - Street 1:17705 HUTCHINS DR STE 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4102
Practice Address - Country:US
Practice Address - Phone:952-401-8300
Practice Address - Fax:952-401-8246
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 1757255163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse