Healthcare Provider Details

I. General information

NPI: 1912991332
Provider Name (Legal Business Name): JANICE LINEHAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 E MAIN AVE
CHEWELAH WA
99109-8964
US

IV. Provider business mailing address

509 E MAIN AVE
CHEWELAH WA
99109-8964
US

V. Phone/Fax

Practice location:
  • Phone: 509-935-6001
  • Fax: 509-935-4196
Mailing address:
  • Phone: 509-935-6001
  • Fax: 509-935-4196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005397
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: