Provider Demographics
NPI:1760499909
Name:SMITH, LINDA DIANE (APN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:540 W PLUMB LN
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3666
Mailing Address - Country:US
Mailing Address - Phone:775-348-1811
Mailing Address - Fax:775-348-7139
Practice Address - Street 1:540 W PLUMB LN
Practice Address - Street 2:SUITE 2A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3666
Practice Address - Country:US
Practice Address - Phone:775-348-1811
Practice Address - Fax:775-348-7139
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN000668364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q29711Medicare UPIN