Provider Demographics
NPI:1730673211
Name:COMEAU, LINDA MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:COMEAU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-1734
Mailing Address - Country:US
Mailing Address - Phone:602-399-1272
Mailing Address - Fax:
Practice Address - Street 1:9327 N 3RD ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2471
Practice Address - Country:US
Practice Address - Phone:602-371-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11412363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily