Healthcare Provider Details

I. General information

NPI: 1639154677
Provider Name (Legal Business Name): LINDA C BURDETT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 S CAMPBELL AVE STE T-1
SPRINGFIELD MO
65807-4980
US

IV. Provider business mailing address

3322 S CAMPBELL AVE STE T-1
SPRINGFIELD MO
65807-4980
US

V. Phone/Fax

Practice location:
  • Phone: 417-220-4480
  • Fax:
Mailing address:
  • Phone: 417-220-4480
  • Fax: 417-900-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2002009459
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: