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General NPI Number Information
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NPI Number | 1134529753
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Entity Type | Individual
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Provider Name | LINDA LEE BOONE AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2400 17TH ST
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City | COLUMBUS
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State | IN
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Zip | 47201-5351
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Country | US
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Telephone | 812-376-5974
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Fax | 812-375-3203
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Provider Business Mailing Address
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Address Line | PO BOX 775383 COLUMBUS REGIONAL HEALTH PHYSICIANS LLC
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City | CHICAGO
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State | IL
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Zip | 60677-5383
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Country | US
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Telephone | 812-376-5315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71005103A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 71005103A
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License Number State | IN
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