Provider Demographics
NPI:1104094747
Name:LINTON, COURTNEY ANN (PA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANN
Last Name:LINTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2461
Mailing Address - Country:US
Mailing Address - Phone:419-238-6251
Mailing Address - Fax:419-238-1652
Practice Address - Street 1:1178 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2461
Practice Address - Country:US
Practice Address - Phone:419-238-6251
Practice Address - Fax:419-238-1652
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002736363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLIPA30501Medicare PIN
OH0559360001Medicare NSC