Provider Demographics
NPI:1689447070
Name:NAHUE, LINA M (RN FNP)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:NAHUE
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18325 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1743
Mailing Address - Country:US
Mailing Address - Phone:818-437-7520
Mailing Address - Fax:
Practice Address - Street 1:18325 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1743
Practice Address - Country:US
Practice Address - Phone:181-843-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524743163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant