Provider Demographics
NPI:1437121241
Name:MESTLER, LINDA M (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MESTLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:CAUDILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:811 W MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2507
Mailing Address - Country:US
Mailing Address - Phone:803-358-6100
Mailing Address - Fax:803-358-6167
Practice Address - Street 1:811 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2507
Practice Address - Country:US
Practice Address - Phone:803-358-6100
Practice Address - Fax:803-358-6167
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF1921363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0893Medicaid
SCNP0893Medicaid
SCAA05788204Medicare PIN