Provider Demographics
NPI:1497978316
Name:GIANI, LINDA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOUISE
Last Name:GIANI
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 1:1401 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-1708
Mailing Address - Country:US
Mailing Address - Phone:907-373-3771
Mailing Address - Fax:907-373-3768
Practice Address - Street 1:1401 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-1708
Practice Address - Country:US
Practice Address - Phone:907-373-3771
Practice Address - Fax:907-373-3768
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK425211251B00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMG482Medicaid
AKCM74821Medicaid