Provider Demographics
NPI:1699777508
Name:DASHIELL, LINDA ANNA (FNP-C CNM)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNA
Last Name:DASHIELL
Suffix:
Gender:F
Credentials:FNP-C CNM
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANNA
Other - Last Name:WILLITS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:220 CONCOURSE BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8210
Mailing Address - Country:US
Mailing Address - Phone:844-527-7369
Mailing Address - Fax:844-847-4943
Practice Address - Street 1:5150 HILL RD E STE C
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-5100
Practice Address - Country:US
Practice Address - Phone:844-527-7369
Practice Address - Fax:844-847-4943
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN421257163W00000X
CA18270363L00000X, 363LF0000X
CA1661367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife