MEDICARE: LINDA W TULLY FNP

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	363L00000X	Nurse Practitioner	R026453	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801863006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA W TULLY FNP

Provider Business Mailing Address
First Line	:	8 SOUTH MAIN ST
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950
Country	:	US
Telephone Number	:	207-696-3992
Fax Number	:	207-696-3974

Provider Business Practice Location Address
First Line	:	8 SOUTH MAIN STREET
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950
Country	:	US
Telephone Number	:	207-696-3992
Fax Number	:	207-696-3974

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/30/2010

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Directions to “ LINDA W TULLY FNP” Practice Location

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