Provider Demographics
NPI:1508156167
Name:JARVIS, LINDA KAY (NMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:KAY
Last Name:JARVIS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 SLAUGHTER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8689
Mailing Address - Country:US
Mailing Address - Phone:256-837-3448
Mailing Address - Fax:256-837-3435
Practice Address - Street 1:1489 SLAUGHTER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8689
Practice Address - Country:US
Practice Address - Phone:256-837-3448
Practice Address - Fax:256-837-3435
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ98-543175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath