Provider Demographics
NPI:1023909959
Name:CHERNOFF, LINDA MAUREEN
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MAUREEN
Last Name:CHERNOFF
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 1:2632 BEARCO LOOP # 88
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-5335
Mailing Address - Country:US
Mailing Address - Phone:208-871-8244
Mailing Address - Fax:
Practice Address - Street 1:1807 COVE AVE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3516
Practice Address - Country:US
Practice Address - Phone:541-663-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10013663363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care