Provider Demographics
NPI:1518297456
Name:DUBOIS, LINDA MARY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6560
Mailing Address - Fax:814-372-2848
Practice Address - Street 1:1102 MILLION DOLLAR HWY
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-2728
Practice Address - Country:US
Practice Address - Phone:814-834-4040
Practice Address - Fax:814-834-6675
Is Sole Proprietor?:No
Enumeration Date:2009-12-27
Last Update Date:2018-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP010600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA177701Medicare PIN