Healthcare Provider Details

I. General information

NPI: 1447350285
Provider Name (Legal Business Name): LINDA J MCKINNEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 STATE HIGHWAY Y
FORSYTH MO
65653-5618
US

IV. Provider business mailing address

1440 ST HWY 248 -J
BRANSON MO
65616
US

V. Phone/Fax

Practice location:
  • Phone: 417-546-4200
  • Fax: 417-546-4505
Mailing address:
  • Phone: 417-239-0706
  • Fax: 417-546-0768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number088946
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: