Provider Demographics
NPI:1447886882
Name:LINDSKOG, MELLIE (RN)
Entity type:Individual
Prefix:MRS
First Name:MELLIE
Middle Name:
Last Name:LINDSKOG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 SPARKS DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-0522
Mailing Address - Country:US
Mailing Address - Phone:214-458-5223
Mailing Address - Fax:
Practice Address - Street 1:2766 SPARKS DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-0522
Practice Address - Country:US
Practice Address - Phone:214-458-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671925163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health