Provider Demographics
NPI:1295836112
Name:LINKOUS, DONNA LEE (C-FNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:LINKOUS
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 902
Mailing Address - Street 2:
Mailing Address - City:SHADY SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:25918-0902
Mailing Address - Country:US
Mailing Address - Phone:681-238-8239
Mailing Address - Fax:304-252-9218
Practice Address - Street 1:1802 HARPER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3375
Practice Address - Country:US
Practice Address - Phone:304-252-9211
Practice Address - Fax:304-252-9218
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7102128000Medicaid
WV7102128000Medicaid
WV9357731Medicare PIN