Provider Demographics
NPI:1508814468
Name:AXMAN, LINNEA MARIE (DRPH, MSN, CFNP)
Entity Type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:MARIE
Last Name:AXMAN
Suffix:
Gender:F
Credentials:DRPH, MSN, CFNP
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Mailing Address - Street 1:4052 TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2637
Mailing Address - Country:US
Mailing Address - Phone:619-813-5732
Mailing Address - Fax:619-225-5704
Practice Address - Street 1:4790 SANTA MONICA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-2209
Practice Address - Country:US
Practice Address - Phone:619-208-1898
Practice Address - Fax:619-223-7186
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704118112363LF0000X
CA787483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily