Healthcare Provider Details

I. General information

NPI: 1275740698
Provider Name (Legal Business Name): LINDA BOUSKILL NAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S DORA ST
UKIAH CA
95482-6340
US

IV. Provider business mailing address

1120 S DORA ST
UKIAH CA
95482-6340
US

V. Phone/Fax

Practice location:
  • Phone: 707-472-2720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN244377
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberRN244377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: