MEDICARE: LINO LAMB AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	122068	AR

General Provider Information

NPI Number	:	1588212575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINO LAMB AGACNP-BC

Provider Business Mailing Address
First Line	:	106 GRAND MAGNOLIA DR
Second Line	:
City	:	GREENWOOD
State	:	AR
Zip	:	72936-4310
Country	:	US
Telephone Number	:	479-597-8222
Fax Number	:

Provider Business Practice Location Address
First Line	:	9001 JENNY LIND RD STE 2
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72908-8629
Country	:	US
Telephone Number	:	479-444-3566
Fax Number	:	479-316-4464

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2019
Last Update Date	:	05/22/2025

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