Provider Demographics
NPI:1689722779
Name:LINKOUS, NANCY L (LMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:LINKOUS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LAVIN
Other - Last Name:LINKOUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 2632
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32655-2632
Mailing Address - Country:US
Mailing Address - Phone:386-454-0394
Mailing Address - Fax:386-454-0394
Practice Address - Street 1:425 NE SANTA FE BLVD.
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643
Practice Address - Country:US
Practice Address - Phone:386-454-0394
Practice Address - Fax:386-454-0394
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA19606225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC8893OtherBLUE CROSS BLUE SHIELD