Lynn Alan Sulerud
Optometrist
12170 Aberdeen St Ne
Blaine
, Minnesota 55449-4716
Lynn Alan Sulerud
Optometrist
12170 Aberdeen St Ne
Blaine
, Minnesota 55449-4716
(763) 757-3328
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Lynn Alan Sulerud
- 12170 Aberdeen St Ne
- Blaine, MN
- Zip : 55449-4716
- Fax : (763) 757-3328
- Phone : (763) 757-7000
Second Address
- Lynn Alan Sulerud
- 12170 Aberdeen St Ne
- Blaine, MN
- Zip : 55449-4716
- Fax : (763) 757-3328
- Phone : (763) 757-7000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1698 | MN |
National Provider Identifier
| NPI | 1013060409 |
|---|---|
| Provider Name | Lynn Alan Sulerud |
| First Address | Blaine, MN 55449-4716 |
| Second Address | Blaine, MN 55449-4716 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/01/2007 |
| Last Update Date | 27/09/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 844523100 | (05) | MN |
| T66186 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.