Provider Demographics
NPI:1790797884
Name:HATLER, LINDA K (PHD, PA-C)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:K
Last Name:HATLER
Suffix:
Gender:F
Credentials:PHD, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VETERANS WAY
Mailing Address - Street 2:JACC C&P
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-9677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 VETERANS WAY
Practice Address - Street 2:JACC C&P
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-9677
Practice Address - Country:US
Practice Address - Phone:850-912-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3466363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
C48898Medicare UPIN