Provider Demographics
NPI:1457304321
Name:KARLE, LINDA S (CNM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:KARLE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-0578
Mailing Address - Country:US
Mailing Address - Phone:334-677-5986
Mailing Address - Fax:334-677-4901
Practice Address - Street 1:1806 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3026
Practice Address - Country:US
Practice Address - Phone:334-677-5986
Practice Address - Fax:334-677-4901
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1062089367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL569900134Medicaid
AL51095599OtherBLUE CROSS
AL51095599OtherBLUE CROSS