Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3006577 | KY |
NPI | 1003121302 |
---|---|
Provider Name | Linda Boarman |
First Address | Owensboro, KY 42303-7805 |
Second Address | Philpot, KY 42366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2010 |
Last Update Date | 27/02/2019 |