Provider Demographics
NPI:1972245900
Name:LINGL, KATIE JEAN (APRN, CRNA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:JEAN
Last Name:LINGL
Suffix:
Gender:F
Credentials:APRN, CRNA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JEAN
Other - Last Name:GROVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4660 LOTUS DR
Mailing Address - Street 2:
Mailing Address - City:MINNETRISTA
Mailing Address - State:MN
Mailing Address - Zip Code:55331-2808
Mailing Address - Country:US
Mailing Address - Phone:952-215-6112
Mailing Address - Fax:
Practice Address - Street 1:201 E NICOLLET BLVD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5714
Practice Address - Country:US
Practice Address - Phone:952-892-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3036367500000X
MN2208994163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse