Provider Demographics
NPI:1568594984
Name:KAPLAN, LINDA S (APRN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN,BC
Mailing Address - Street 1:1200 N BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3118
Mailing Address - Country:US
Mailing Address - Phone:928-213-6235
Mailing Address - Fax:
Practice Address - Street 1:61 BELL ROCK ROAD
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336
Practice Address - Country:US
Practice Address - Phone:928-204-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003405363LF0000X, 363LP0808X
AZAP11556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400001904Medicare PIN