Provider Demographics
NPI:1053577783
Name:POGEMILLER, LINDSEY LEIGH (ANP-BC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LEIGH
Last Name:POGEMILLER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE SOUTH
Mailing Address - Street 2:HENNEPIN COUNTY MEDICAL CENTER/REVENUE MANAGEMENT
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415
Mailing Address - Country:US
Mailing Address - Phone:612-873-3044
Mailing Address - Fax:612-630-8242
Practice Address - Street 1:701 PARK AVE SOUTH
Practice Address - Street 2:HENNEPIN COUNTY MEDICAL CENTER/REVENUE MANAGEMENT
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415
Practice Address - Country:US
Practice Address - Phone:612-873-3044
Practice Address - Fax:612-630-8242
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2008004213363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR160673-3OtherNURSE PRACTIONER