Provider Demographics
NPI:1336468529
Name:MAGGARD, LINDA PEAVLEY (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:PEAVLEY
Last Name:MAGGARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UK DIVISON OF PULMONARY
Mailing Address - Street 2:740 S. LIMESTONE, L543 KY CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-9555
Mailing Address - Fax:859-257-9286
Practice Address - Street 1:UK DIVISON OF PULMONARY
Practice Address - Street 2:740 S. LIMESTONE, L543 KY CLINIC
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-323-9555
Practice Address - Fax:859-257-9286
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006467363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00931548OtherRAILROAD MEDICARE
KY000000681317OtherANTHEM
KY7100140810Medicaid
KY7100140810Medicaid