Individual provider Active NPI

Linda G Lau, ANP

  • Pediatric Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1396859690
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NUR-RN-LIC-68162 Issued in MT
Practice address
2835 Fort Missoula Rd
Building 3, Suite 301
Missoula, MT 59804-7423
Phone
(406) 327-4279
NPI assigned
Aug 17, 2006
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 868 AK
Pediatric Nurse Practitioner 363LP0200X NUR-RN-LIC-68162 MT Primary

Addresses

Primary practice location

2835 Fort Missoula Rd
Building 3, Suite 301
Missoula, MT 59804-7423

Mailing address

2835 Fort Missoula Rd
Building 3, Suite 301
Missoula, MT 59804-7423
Phone (406) 327-4279

Other identifiers 1

IdentifierTypeStateIssuer
NP0867MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
868AKMDPediatric Nurse Practitioner
NUR-RN-LIC-68162MTMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1396859690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD",
            "address_2": "BUILDING 3, SUITE 301",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047423",
            "telephone_number": "406-327-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD",
            "address_2": "BUILDING 3, SUITE 301",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047423",
            "telephone_number": "406-327-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "LINDA",
        "middle_name": "G",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AK",
            "license": "868",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MT",
            "license": "NUR-RN-LIC-68162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0867",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.