Provider Demographics
NPI:1689862252
Name:LAFFERTY, LINDA (DO, MS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6112
Mailing Address - Country:US
Mailing Address - Phone:775-828-5100
Mailing Address - Fax:
Practice Address - Street 1:6580 S MCCARRAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6112
Practice Address - Country:US
Practice Address - Phone:775-828-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVDO366Medicare PIN