Healthcare Provider Details

I. General information

NPI: 1780701086
Provider Name (Legal Business Name): LINDA M GUYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA M FORREST RN

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 BAYOU ST
VINCENNES IN
47591-1034
US

IV. Provider business mailing address

515 BAYOU ST
VINCENNES IN
47591-1034
US

V. Phone/Fax

Practice location:
  • Phone: 812-886-6800
  • Fax: 812-886-6809
Mailing address:
  • Phone: 812-886-6800
  • Fax: 812-886-6809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28166598A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: