Healthcare Provider Details

I. General information

NPI: 1619959376
Provider Name (Legal Business Name): LINDA MARIE PLUSH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38656 MEDICAL CENTER DRIVE #C SUITE SUMMIT URGENT CARE
PALMDALE CA
93551
US

IV. Provider business mailing address

38660 MEDICAL CENTER DRIVE #A130 SUMMIT URGENT CARE
PALMDALE CA
93551
US

V. Phone/Fax

Practice location:
  • Phone: 661-273-7100
  • Fax: 661-208-4885
Mailing address:
  • Phone: 661-273-7100
  • Fax: 661-208-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberCNS 159
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberFNP 11365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: