Provider Demographics
NPI:1558978510
Name:FOUCHE, LINDA B
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:FOUCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 HIGHWAY 61 N
Mailing Address - Street 2:
Mailing Address - City:PORT GIBSON
Mailing Address - State:MS
Mailing Address - Zip Code:39150-4262
Mailing Address - Country:US
Mailing Address - Phone:601-437-3050
Mailing Address - Fax:601-437-3051
Practice Address - Street 1:2045 HIGHWAY 61 N
Practice Address - Street 2:
Practice Address - City:PORT GIBSON
Practice Address - State:MS
Practice Address - Zip Code:39150-4262
Practice Address - Country:US
Practice Address - Phone:601-437-3050
Practice Address - Fax:601-437-3051
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator