Healthcare Provider Details

I. General information

NPI: 1285833004
Provider Name (Legal Business Name): LINDA MCCAMPBELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 SECOND ST
PORT ISABEL TX
78578-4100
US

IV. Provider business mailing address

150 BEACH BLVD
LAGUNA VISTA TX
78578-2636
US

V. Phone/Fax

Practice location:
  • Phone: 956-943-1774
  • Fax: 956-421-2787
Mailing address:
  • Phone: 956-943-1774
  • Fax: 856-421-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number439218
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: