National Provider Identifier Database

LYNN K GUSTAFSON, DPM – NPI #1124006143
Podiatrist

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

LYNN K GUSTAFSON, DPM
1421 PREMIERE DR
MANKATO CLINIC @ WICKERSHAM CAMPUS
MANKATO, MN56001
Phone: 507-625-1811
Fax:
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X

* Indicates primary specialty

NPI Profile & details for LYNN K GUSTAFSON

NPI Number 1124006143
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 01/09/2006
Last updated 07/10/2020 - About 6 years ago
Sole proprietor1 No
Identifiers
  • MN License #: 492
  • MN Medicaid: 704325200
  • Other: 1753435 AMERICA'S PPO (MN)
  • Other: 1M845GU BCBS (MN)
  • Other: HP26296 HEALTH PARTNERS (MN)
  • Other: 2700674 MEDICA (MN)
  • Other: 937961 MEDICAID (IOWA)
  • Other: NA2951011002 PREFERRED ONE (MN)
  • Other: 480018263 RR MEDICARE
  • Other: 115542 UCARE (MN)
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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