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General NPI Number Information
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NPI Number | 1235016387
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Entity Type | Individual
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Provider Name | LINNIE ANN WILLSON RN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 40 ORRS LN
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City | TRIADELPHIA
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State | WV
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Zip | 26059-1455
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Country | US
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Telephone | 304-547-9197
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Fax | 304-547-9198
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Provider Business Mailing Address
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Address Line | 40 ORRS LN
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City | TRIADELPHIA
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State | WV
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Zip | 26059-1455
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Country | US
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Telephone | 304-547-9197
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Fax | 304-547-9198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 118842
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License Number State | WV
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