Provider Demographics
NPI:1720963374
Name:LINDBERG, TUCKER (MSN, APNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TUCKER
Middle Name:
Last Name:LINDBERG
Suffix:
Gender:M
Credentials:MSN, APNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 RESTORMEL ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806-1364
Mailing Address - Country:US
Mailing Address - Phone:218-969-7478
Mailing Address - Fax:
Practice Address - Street 1:3070 RESTORMEL ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55806-1364
Practice Address - Country:US
Practice Address - Phone:218-969-7478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN132122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry