Basic Information
| Provider Information | |||||||||
| NPI: | 1225646185 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINAWEAVER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | HOPE | ||||||||
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| Credential: | NURSE ANESTHETIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6401 PATTERSON PKWY | ||||||||
| Address2: | |||||||||
| City: | ARKANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670055701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6204415798 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6401 PATTERSON PKWY | ||||||||
| Address2: | |||||||||
| City: | ARKANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670055701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6204415798 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2020 | ||||||||
| LastUpdateDate: | 07/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 43557788 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.