Provider Demographics
NPI:1003121302
Name:BOARMAN, LINDA (ARNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BOARMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 MOUNT MORIAH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7805
Mailing Address - Country:US
Mailing Address - Phone:270-683-4726
Mailing Address - Fax:270-926-0220
Practice Address - Street 1:6071 HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:PHILPOT
Practice Address - State:KY
Practice Address - Zip Code:42366
Practice Address - Country:US
Practice Address - Phone:270-713-0177
Practice Address - Fax:270-713-0185
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily