Healthcare Provider Details

I. General information

NPI: 1467010033
Provider Name (Legal Business Name): LINDA XUAN WEST FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 STATE ST
SCHENECTADY NY
12307-1508
US

IV. Provider business mailing address

165 FIELDSTONE DR
SCHENECTADY NY
12304-5413
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-1441
  • Fax: 518-395-9431
Mailing address:
  • Phone: 818-486-0456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF08181127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: