Healthcare Provider Details

I. General information

NPI: 1952480014
Provider Name (Legal Business Name): LINDA M BROWN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 W HIGH ST STE 150
LIMA OH
45801-3961
US

IV. Provider business mailing address

750 W HIGH ST STE 150
LIMA OH
45801-3961
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-1359
  • Fax: 419-227-7586
Mailing address:
  • Phone: 419-227-1359
  • Fax: 419-227-7586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP08994
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: