Provider Demographics
NPI:1760577845
Name:BERTINASCO, LINDA GIOIA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GIOIA
Last Name:BERTINASCO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 408
Mailing Address - Street 2:
Mailing Address - City:SOLSBERRY
Mailing Address - State:IN
Mailing Address - Zip Code:47459-8310
Mailing Address - Country:US
Mailing Address - Phone:317-750-4852
Mailing Address - Fax:
Practice Address - Street 1:1001 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2859
Practice Address - Country:US
Practice Address - Phone:317-630-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28123891A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INQ42274Medicare UPIN