Provider Demographics
NPI:1821733304
Name:LINTON, KENISHA
Entity Type:Individual
Prefix:DR
First Name:KENISHA
Middle Name:
Last Name:LINTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SHAWNEE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-7799
Mailing Address - Country:US
Mailing Address - Phone:718-514-3494
Mailing Address - Fax:
Practice Address - Street 1:851 COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18519-1759
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025270363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health