Provider Demographics
NPI:1255941795
Name:NOVAK, LINETTE MAE (APRN, CNP)
Entity type:Individual
Prefix:MS
First Name:LINETTE
Middle Name:MAE
Last Name:NOVAK
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:LINETTE
Other - Middle Name:MAE
Other - Last Name:MAKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:400 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-8364
Mailing Address - Fax:
Practice Address - Street 1:1101 9TH ST N
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2329
Practice Address - Country:US
Practice Address - Phone:218-305-0000
Practice Address - Fax:401-946-5862
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02404363LF0000X
MN10284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily