Provider Demographics
NPI:1740369909
Name:DEVINE, LINDA M (CRNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:DEVINE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:FORBES TOWER, SUITE 10055 B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-864-0594
Mailing Address - Fax:412-647-3222
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:FORBES TOWER, SUITE 10055 B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-864-0594
Practice Address - Fax:412-647-3222
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004456B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102979834Medicaid
PA102979834Medicaid