Healthcare Provider Details

I. General information

NPI: 1689732661
Provider Name (Legal Business Name): LINDA ANN HODSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA CARLISLE ARNP

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 11/01/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 SHERIDAN STREET
PORT TOWNSEND WA
98368
US

IV. Provider business mailing address

PO BOX 220507
ANCHORAGE AK
99522-0507
US

V. Phone/Fax

Practice location:
  • Phone: 360-385-4848
  • Fax: 360-379-4383
Mailing address:
  • Phone: 907-360-4290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30003940
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number465
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30003940
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: