Provider Demographics
NPI:1710575410
Name:PIERRE-PAUL, LINDA REBECCA (ARNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:REBECCA
Last Name:PIERRE-PAUL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 REFLECTIONS BLVD APT 207
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8241
Mailing Address - Country:US
Mailing Address - Phone:305-741-1847
Mailing Address - Fax:
Practice Address - Street 1:9916 NE HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-5608
Practice Address - Country:US
Practice Address - Phone:360-954-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9523522163WH0200X
FL11017528363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL780379Medicaid