Healthcare Provider Details

I. General information

NPI: 1568507986
Provider Name (Legal Business Name): LINDA SALEM FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15167 HUNTINGTON RD
GALLIPOLIS FERRY WV
25515-6615
US

IV. Provider business mailing address

PO BOX 1680
HUNTINGTON WV
25717-1680
US

V. Phone/Fax

Practice location:
  • Phone: 304-675-5725
  • Fax: 304-675-5727
Mailing address:
  • Phone: 304-697-1396
  • Fax: 304-697-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32850
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: