Provider Demographics
NPI:1023391067
Name:LEA, LINDA LEE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:LEA
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4117 NW 122ND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8869
Mailing Address - Country:US
Mailing Address - Phone:405-607-6770
Mailing Address - Fax:405-607-6774
Practice Address - Street 1:4117 NW 122ND ST
Practice Address - Street 2:SUITE C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8869
Practice Address - Country:US
Practice Address - Phone:405-607-6770
Practice Address - Fax:405-607-6774
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK62315363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health