Provider Demographics
NPI:1912266115
Name:COTHRON, LINDA (ARNP, MS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:COTHRON
Suffix:
Gender:F
Credentials:ARNP, MS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15210 AMBERLY DR
Mailing Address - Street 2:APT 1916
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2196
Mailing Address - Country:US
Mailing Address - Phone:727-967-6571
Mailing Address - Fax:
Practice Address - Street 1:15210 AMBERLY DR
Practice Address - Street 2:APT 1916
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2196
Practice Address - Country:US
Practice Address - Phone:727-967-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2511732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily