Provider Demographics
NPI:1013514686
Name:LINNEY, JENNIFER JEAN (RN, FNP, AGACNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:LINNEY
Suffix:
Gender:F
Credentials:RN, FNP, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 DUBLIN SQUARE RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-8601
Mailing Address - Country:US
Mailing Address - Phone:336-521-9480
Mailing Address - Fax:534-429-4406
Practice Address - Street 1:138 DUBLIN SQUARE RD STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8601
Practice Address - Country:US
Practice Address - Phone:336-610-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014275363L00000X
NC208624163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Single Specialty