Provider Demographics
NPI:1568709228
Name:LINSS, AMY MICHELLE (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:LINSS
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 S BALTIMORE ST STE A
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4519
Mailing Address - Country:US
Mailing Address - Phone:660-665-7575
Mailing Address - Fax:660-665-7576
Practice Address - Street 1:900 E LAHARPE ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4520
Practice Address - Country:US
Practice Address - Phone:660-665-1962
Practice Address - Fax:660-665-3989
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012020052163W00000X
MO2019025834363LP0808X
MO2017026423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1568709228Medicaid
MO420047513Medicaid