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NPI Code Detail

MEDICARE: MRS. LINDA LOUISE PIETZ FNP

MEDICARE: MRS. LINDA LOUISE PIETZ 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
1363L00000XNurse Practitioner133307MO
2363L00000XNurse Practitioner5019030NC

General Provider Information

NPI Number : 1841612678
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA LOUISE PIETZ FNP
Provider Business Mailing Address
First Line : PO BOX 746724
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6724
Country : US
Telephone Number : 312-733-9730
Fax Number : 417-269-8333
Provider Business Practice Location Address
First Line : 103 COUNTRY CLUB DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-7603
Country : US
Telephone Number : 910-400-7002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2014
Last Update Date : 12/18/2023

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