Provider Demographics
NPI:1376581710
Name:VOLNESS, LINDA JO (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JO
Last Name:VOLNESS
Suffix:
Gender:F
Credentials:APRN, CNS
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 2309
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-2309
Mailing Address - Country:US
Mailing Address - Phone:701-478-0333
Mailing Address - Fax:701-478-0434
Practice Address - Street 1:1316 23RD ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3707
Practice Address - Country:US
Practice Address - Phone:701-478-0333
Practice Address - Fax:701-478-0434
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR21956364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND712222Medicare PIN
NDP52294Medicare UPIN