Provider Demographics
NPI:1609946243
Name:LINMAN, SINA J (APRN)
Entity type:Individual
Prefix:
First Name:SINA
Middle Name:J
Last Name:LINMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3135 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-3359
Mailing Address - Country:US
Mailing Address - Phone:712-328-9100
Mailing Address - Fax:402-328-0095
Practice Address - Street 1:1 EDMUNDSON PL
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-396-4310
Practice Address - Fax:712-396-4180
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA052795363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1609946243Medicaid
NE47068731712Medicaid
NE1609946243Medicaid
NE47068731712Medicaid