Individual provider Active NPI

Linda Haines Self, FNP-C

  • Family Nurse Practitioner
  • Houlton, ME
National Provider Identifier
1093776361
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP111009 Issued in ME
Practice address
22 Hartford St
Houlton, ME 04730-1844
Phone
(207) 532-3289
Fax
(207) 532-6071
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP111009 ME Primary

Addresses

Primary practice location

22 Hartford St
Houlton, ME 04730-1844

Mailing address

1543 County Road 3350
Clarksville, AR 72830-8162
Phone (479) 754-0851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000496 ME Practitioner - Nurse Practitioner 2466621552 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP111009MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houlton Regional Hospital CurrentSince Feb 6, 2018 Accepting new patients
Houlton Regional Hospital CurrentSince Feb 6, 2018 Accepting new patients

Locations

20 Hartford St
Houlton, ME 04730
Phone (207) 532-2900

22 Hartford St
Houlton, ME 04730
Phone (207) 532-3289

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093776361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 COUNTY ROAD 3350",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728308162",
            "telephone_number": "479-754-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HARTFORD ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301844",
            "telephone_number": "207-532-3289",
            "fax_number": "207-532-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "LINDA",
        "middle_name": "HAINES",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP111009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houlton, ME

Sources for this page

Verify at the official NPI Registry.