NORTHERN LIGHTS HEALTH LLC NPI 1316581440

NPI Information

NPI: 1316581440
Provider Name: NORTHERN LIGHTS HEALTH LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 24D2199463

Address:
212 W LAKE ST
WACONIA, MN
ZIP 55387
Phone: (920) 217-9035
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NORTHERN LIGHTS HEALTH LLC is a primary care nurse practitioner in Waconia, MN. NORTHERN LIGHTS HEALTH LLC NPI is 1316581440. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

212 W LAKE ST
WACONIA, MN
ZIP 55387-014
Phone: (920) 217-9035

The provider's authorized official is Nicole M Siddons .
The authorized official title is Co-founder and has the following contact phone number (920) 217-9035.

The CLIA number assigned to this NPI record is 24D2199463 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2019 and was last updated on 12/22/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	No
2	363LA2200X	Nurse Practitioner	Adult Health	No
3	363LF0000X	Nurse Practitioner	Family	No
4	363LG0600X	Nurse Practitioner	Gerontology	No
5	363LP2300X	Nurse Practitioner	Primary Care	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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