Doctor Name: | MS. LINDA MARIE PEDERSEN |
NPI Number: | 1164572590 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MNARNP |
License Number: | AP30004070 |
Business Practice Address: | 121 Oak Bay Road Port Hadlock, WA - 98339 |
Business Phone Number: | 3603796737 |
Business Fax Number: | 3603796518 |
Mailing Address: | Po Box 1208, PORT HADLOCK |
State: | WA |
Postal Code: | 983391208 |
Phone Number: | 3603796737 |
Fax Number: | 3603796518 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 07/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP30004070 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |