Provider Demographics
NPI:1497292999
Name:LINDA BOARMAN FNP PLLC
Entity Type:Organization
Organization Name:LINDA BOARMAN FNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:270-713-0177
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366-0070
Mailing Address - Country:US
Mailing Address - Phone:270-713-0177
Mailing Address - Fax:
Practice Address - Street 1:6071 HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:PHILPOT
Practice Address - State:KY
Practice Address - Zip Code:42366
Practice Address - Country:US
Practice Address - Phone:270-713-0177
Practice Address - Fax:270-713-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty