Provider Demographics
NPI:1508814468
Name:AXMAN, LINNEA MARIE (DRPH, DNP, MSN, FNP)
Entity type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:MARIE
Last Name:AXMAN
Suffix:
Gender:F
Credentials:DRPH, DNP, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 QUAIL RUN CT
Mailing Address - Street 2:
Mailing Address - City:CLARKDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:86324-3013
Mailing Address - Country:US
Mailing Address - Phone:619-813-5732
Mailing Address - Fax:
Practice Address - Street 1:250 QUAIL RUN CT
Practice Address - Street 2:
Practice Address - City:CLARKDALE
Practice Address - State:AZ
Practice Address - Zip Code:86324-3013
Practice Address - Country:US
Practice Address - Phone:928-488-1037
Practice Address - Fax:619-223-7186
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704118112363LF0000X
CA787483363LF0000X
AZ248672363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily