Provider Demographics
NPI:1649014754
Name:LIND, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LIND
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 1:4253 TIMBERRIDGE LN APT B
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4014
Mailing Address - Country:US
Mailing Address - Phone:218-721-7534
Mailing Address - Fax:
Practice Address - Street 1:4253 TIMBERRIDGE LN APT B
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-4014
Practice Address - Country:US
Practice Address - Phone:218-721-7534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN756150164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse