Provider Demographics
NPI:1699813329
Name:LINN, LIZABETH ANN (ARNP, FNP)
Entity Type:Individual
Prefix:
First Name:LIZABETH
Middle Name:ANN
Last Name:LINN
Suffix:
Gender:F
Credentials:ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 HOLLY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3455
Mailing Address - Country:US
Mailing Address - Phone:925-381-6890
Mailing Address - Fax:
Practice Address - Street 1:597 CENTER AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4640
Practice Address - Country:US
Practice Address - Phone:925-313-6150
Practice Address - Fax:925-313-6188
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN145802363LF0000X
AZAP2697363LF0000X
WAAP60056949363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACD8128OtherRR MEDICARE #
WA9662446Medicaid
WAAP60056949OtherWA LICENSE
WAG000188100Medicare PIN
WACD8128OtherRR MEDICARE #
WA9662446Medicaid
WAAB13179Medicare PIN
WAOO1045700Medicare PIN
WAG001045700Medicare PIN
WAG8880511Medicare PIN
WAG8882801Medicare PIN
WAAP60056949OtherWA LICENSE
WAG8851594Medicare PIN
WA8851594Medicare PIN
AZZ127056Medicare PIN
WAG8882800Medicare PIN
WAG8851597Medicare PIN