Provider Demographics
NPI:1790858496
Name:MOUNTS, LINDA L (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:MOUNTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7729 W 510 S
Mailing Address - Street 2:
Mailing Address - City:WESTPOINT
Mailing Address - State:IN
Mailing Address - Zip Code:47992-9323
Mailing Address - Country:US
Mailing Address - Phone:765-572-2558
Mailing Address - Fax:
Practice Address - Street 1:7729 W 510 S
Practice Address - Street 2:
Practice Address - City:WESTPOINT
Practice Address - State:IN
Practice Address - Zip Code:47992-9323
Practice Address - Country:US
Practice Address - Phone:765-572-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000387A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INS53886Medicare UPIN