Provider Demographics
NPI:1053713586
Name:LINNEWEBER, LINDA (FNP-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LINNEWEBER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1698 S 100 W
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-9351
Mailing Address - Country:US
Mailing Address - Phone:812-253-7213
Mailing Address - Fax:812-253-7165
Practice Address - Street 1:1698 S 100 W
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-9351
Practice Address - Country:US
Practice Address - Phone:812-253-7213
Practice Address - Fax:812-253-7165
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005130A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN363LF0000XOtherTAXONOMY
IN71005130AOtherIN LICENSE
IN100270150OtherMEDICAID GROUP
IN363LF0000XOtherTAXONOMY
IN941140OtherMEDICARE GROUP
IN71005130AOtherIN LICENSE