Provider Demographics
NPI:1316715386
Name:MALM, LINNEA ERICA (CNM)
Entity type:Individual
Prefix:
First Name:LINNEA
Middle Name:ERICA
Last Name:MALM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 MAIN ST APT C
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-1332
Mailing Address - Country:US
Mailing Address - Phone:603-957-0533
Mailing Address - Fax:
Practice Address - Street 1:3 ALUMNI DR STE 401
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2123
Practice Address - Country:US
Practice Address - Phone:603-778-0557
Practice Address - Fax:603-778-1669
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH092725-23367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife