Healthcare Provider Details

I. General information

NPI: 1457442642
Provider Name (Legal Business Name): LINDA J. BEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 HARTFORD ST
LAFAYETTE IN
47904-2173
US

IV. Provider business mailing address

1716 HARTFORD ST
LAFAYETTE IN
47904-2173
US

V. Phone/Fax

Practice location:
  • Phone: 765-742-1567
  • Fax: 765-429-6961
Mailing address:
  • Phone: 765-742-1567
  • Fax: 765-429-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number28058318A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: