Provider Demographics
NPI:1477606242
Name:POIRIER, LINDA (RN FNPC APNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:POIRIER
Suffix:
Gender:F
Credentials:RN FNPC APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SO BARSTOW
Mailing Address - Street 2:1B
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701
Mailing Address - Country:US
Mailing Address - Phone:715-832-9292
Mailing Address - Fax:715-832-4172
Practice Address - Street 1:130 SO BARSTOW
Practice Address - Street 2:1B
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701
Practice Address - Country:US
Practice Address - Phone:715-832-9292
Practice Address - Fax:715-832-4172
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI684 033 APNP363L00000X
WI85943 030 NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43898700Medicaid
S72246Medicare UPIN
WI43898700Medicaid