Healthcare Provider Details

I. General information

NPI: 1457565939
Provider Name (Legal Business Name): LINDA MICHELE SIPLE RN FNP MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 MANETTO HILL RD SUITE 110
PLAINVIEW NY
11803
US

IV. Provider business mailing address

146 MANETTO HILL RD SUITE 110
PLAINVIEW NY
11803
US

V. Phone/Fax

Practice location:
  • Phone: 516-933-3333
  • Fax:
Mailing address:
  • Phone: 516-933-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF3332081
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: