Healthcare Provider Details

I. General information

NPI: 1912911496
Provider Name (Legal Business Name): LINDA TINKER FERRETTI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 MONTGOMERY BLVD NE STE 215
ALBUQUERQUE NM
87111-2579
US

IV. Provider business mailing address

2836 SICOMORO LN SE
RIO RANCHO NM
87124-3288
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-4224
  • Fax:
Mailing address:
  • Phone: 505-892-9869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberKY-0402
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: