Provider Demographics
NPI:1235198078
Name:FERRARIO, LINDA K
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:FERRARIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2165 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2707
Practice Address - Country:US
Practice Address - Phone:651-523-9800
Practice Address - Fax:651-523-9801
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30920207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080012729Medicaid
MN108018OtherUCARE
MN555K3FEOtherBCBS
MN01-21096OtherMEDICA
MNHP13273OtherHEALTH PARTNERS
MNNA9020180013OtherPERFERRED ONE
MNHP13273OtherHEALTH PARTNERS
MNE28140Medicare UPIN