Provider Demographics
NPI:1518033042
Name:HUMPHREY, LINDA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:JEAN
Other - Last Name:SLINGERLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 SOUTH ARLINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-2002
Mailing Address - Country:US
Mailing Address - Phone:775-348-1900
Mailing Address - Fax:775-348-1904
Practice Address - Street 1:235 WEST 6TH STREET
Practice Address - Street 2:SAINT MARYS REGIONAL MEDICAL CENTER
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4548
Practice Address - Country:US
Practice Address - Phone:775-770-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6023207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B67005Medicare UPIN
05WCGVN25Medicare ID - Type Unspecified