Provider Demographics
NPI:1083836886
Name:SMITH, LINDA MCKENNON (RNC, MS, NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MCKENNON
Last Name:SMITH
Suffix:
Gender:F
Credentials:RNC, MS, NP
Other - Prefix:
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Mailing Address - Street 1:1171 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2505
Mailing Address - Country:US
Mailing Address - Phone:515-235-0429
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:3729 N CROSSOVER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4582
Practice Address - Country:US
Practice Address - Phone:479-443-7791
Practice Address - Fax:479-443-5761
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA001096363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health