Provider Demographics
NPI:1477923316
Name:BOTTS, LINDA KATHRYN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KATHRYN
Last Name:BOTTS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 E MILLBROOK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4971
Mailing Address - Country:US
Mailing Address - Phone:919-341-4016
Mailing Address - Fax:
Practice Address - Street 1:1033 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5785
Practice Address - Country:US
Practice Address - Phone:336-860-0843
Practice Address - Fax:336-313-5944
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF0815035363LF0000X
NC5008079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily