Provider Demographics
NPI:1558693093
Name:NASSER, LINDA SUE (R PH)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:NASSER
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4744
Mailing Address - Country:US
Mailing Address - Phone:605-367-2839
Mailing Address - Fax:605-367-2853
Practice Address - Street 1:2701 S MINNESOTA AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4744
Practice Address - Country:US
Practice Address - Phone:605-367-2839
Practice Address - Fax:605-367-2853
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist