Provider Demographics
NPI:1871560441
Name:STUBER, LYNDA JEAN (CPNP)
Entity type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:JEAN
Last Name:STUBER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:JEAN
Other - Last Name:KEMPKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140001 RIDGEDALE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1781
Mailing Address - Country:US
Mailing Address - Phone:952-473-0211
Mailing Address - Fax:952-473-7908
Practice Address - Street 1:14001 RIDGEDALE DR
Practice Address - Street 2:STE 100
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1781
Practice Address - Country:US
Practice Address - Phone:952-473-0211
Practice Address - Fax:952-473-7908
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI290-033363LP0200X
MNR177423-8363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics