Healthcare Provider Details

I. General information

NPI: 1841885696
Provider Name (Legal Business Name): PADMA JOTHI LINGA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 S WASHINGTON AVE
SAGINAW MI
48601-2510
US

IV. Provider business mailing address

3201 HALLMARK CT
SAGINAW MI
48603-2109
US

V. Phone/Fax

Practice location:
  • Phone: 989-401-9015
  • Fax:
Mailing address:
  • Phone: 989-790-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03210002
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number4704269302
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704269302
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2023165398
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: