Provider Demographics
NPI:1619959376
Name:PLUSH, LINDA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:PLUSH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38660 MEDICAL CENTER DRIVE #A130
Mailing Address - Street 2:SUMMIT URGENT CARE
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551
Mailing Address - Country:US
Mailing Address - Phone:661-273-7100
Mailing Address - Fax:661-208-4885
Practice Address - Street 1:38656 MEDICAL CENTER DRIVE #C SUITE
Practice Address - Street 2:SUMMIT URGENT CARE
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551
Practice Address - Country:US
Practice Address - Phone:661-273-7100
Practice Address - Fax:661-208-4885
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS 159364SA2200X
CAFNP 11365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNP 11365OtherFAMILY NURSE PRACTITIONER
CARN 294762OtherRN LICENSE
CA11365OtherPRACTITIONER FURNISHING
CACNS 159OtherCLINICAL NURSE SPECIALIST
CACNS 159OtherCLINICAL NURSE SPECIALIST