Provider Demographics
NPI:1295874253
Name:BURDETTE, LINDA KAY (CNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-2026
Mailing Address - Country:US
Mailing Address - Phone:605-225-0824
Mailing Address - Fax:
Practice Address - Street 1:402 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4127
Practice Address - Country:US
Practice Address - Phone:605-626-2628
Practice Address - Fax:605-626-2974
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDRO14342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily