Provider Demographics
NPI:1649376732
Name:WROTEN, LINDA MARIE (A/GNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:WROTEN
Suffix:
Gender:F
Credentials:A/GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31432
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1432
Mailing Address - Country:US
Mailing Address - Phone:520-314-3412
Mailing Address - Fax:520-314-3413
Practice Address - Street 1:6890 E SUNRISE DR
Practice Address - Street 2:SUITE 120-176
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-0738
Practice Address - Country:US
Practice Address - Phone:520-314-3412
Practice Address - Fax:520-314-3413
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX512384363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP0046OtherBCBS
NP0114OtherBCBS
NP0137OtherBCBS
752720593OtherTRICARE
NP0046OtherBCBS
752720593OtherTRICARE
NP0137OtherBCBS
TXR64726Medicare UPIN
TX131034409Medicaid
752720593OtherTRICARE
TX131034408Medicaid