Provider Demographics
NPI:1932164084
Name:CABINE, LINDA G (ANP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:G
Last Name:CABINE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 DUSTY LAKE DR
Mailing Address - Street 2:STE G1
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-9056
Mailing Address - Country:US
Mailing Address - Phone:870-536-6600
Mailing Address - Fax:870-850-7959
Practice Address - Street 1:209 NORTH BLAKE ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:72201
Practice Address - Country:US
Practice Address - Phone:870-536-6600
Practice Address - Fax:870-850-7959
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W332OtherMEDICARE
ARP25891OtherUPIN
AR157705758Medicaid