Provider Demographics
NPI:1295574606
Name:ANDERSSON, LINNEA PIA
Entity type:Individual
Prefix:
First Name:LINNEA
Middle Name:PIA
Last Name:ANDERSSON
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 1:40 EMERSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-5326
Mailing Address - Country:US
Mailing Address - Phone:970-343-2150
Mailing Address - Fax:
Practice Address - Street 1:40 EMERSON ST APT 1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-5326
Practice Address - Country:US
Practice Address - Phone:970-343-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant