Provider Demographics
NPI:1881643062
Name:HEMPHILL, LINNEA ESTHER (NP)
Entity Type:Individual
Prefix:MRS
First Name:LINNEA
Middle Name:ESTHER
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:NETARTS
Mailing Address - State:OR
Mailing Address - Zip Code:97143-0275
Mailing Address - Country:US
Mailing Address - Phone:303-550-2090
Mailing Address - Fax:
Practice Address - Street 1:4830 CRAB AVE W
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-9413
Practice Address - Country:US
Practice Address - Phone:303-550-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89748363LA2200X
CO3666363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14235838Medicaid
CO022421OtherKAISER COMMERCIAL NUMBER
COCOAAA2940Medicare PIN