Provider Demographics
NPI:1134403157
Name:LINDA LEA, APRN-CNP, PLLC
Entity type:Organization
Organization Name:LINDA LEA, APRN-CNP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:405-753-9600
Mailing Address - Street 1:13313 N MERIDIAN AVE
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8380
Mailing Address - Country:US
Mailing Address - Phone:405-753-9600
Mailing Address - Fax:405-753-9601
Practice Address - Street 1:13313 N MERIDIAN AVE
Practice Address - Street 2:SUITE A-3
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8380
Practice Address - Country:US
Practice Address - Phone:405-753-9600
Practice Address - Fax:405-753-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62315363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty