Provider Demographics
NPI:1801667928
Name:LINN, SHELBY ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ELIZABETH
Last Name:LINN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:E
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11854 HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45882-8800
Mailing Address - Country:US
Mailing Address - Phone:419-605-6106
Mailing Address - Fax:
Practice Address - Street 1:11854 HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:OH
Practice Address - Zip Code:45882-8800
Practice Address - Country:US
Practice Address - Phone:419-605-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014899A363LF0000X
OHAPRN.CNP.0035631363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1103831873OtherANTHEM PTAN
IN300088705Medicaid