Individual
MRS. TRACI ALICE LINDENAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3845 W 4700 S, TAYLORSVILLE, UT 84129-3454
(801) 840-2000
Mailing address
3202 CLAYTON WOODS DR, HOUSTON, TX 77082-4062
(801) 647-4718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05225
TX
363AM0700X
Medical Physician Assistant
6482385-1206
UT
363AM0700X
Medical Physician Assistant
6482385-8906
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212094101
—
TX
05
—
212094102
—
TX
Enumeration date
02/23/2007
Last updated
03/17/2018
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