Provider Demographics
NPI:1477571859
Name:SIEMER, LINDA A (RN, BCFNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:SIEMER
Suffix:
Gender:F
Credentials:RN, BCFNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:A
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1707 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-2641
Mailing Address - Country:US
Mailing Address - Phone:660-339-8500
Mailing Address - Fax:
Practice Address - Street 1:1707 E 9TH ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-2641
Practice Address - Country:US
Practice Address - Phone:660-339-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO423909712Medicaid
MO423909712Medicaid
S57338Medicare UPIN