Provider Demographics
NPI:1780649152
Name:ALLEN, LINDA S (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:ALLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3388
Mailing Address - Country:US
Mailing Address - Phone:318-649-5300
Mailing Address - Fax:318-649-0052
Practice Address - Street 1:484 COLLINS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3388
Practice Address - Country:US
Practice Address - Phone:318-649-5300
Practice Address - Fax:318-649-0052
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN036512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1564893Medicaid
LA595463Medicare UPIN
LA5P282Medicare PIN