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General NPI Number Information
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NPI Number | 1205800349
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Entity Type | Individual
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Provider Name | LINDA GRACE PHELPS WHCNP
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Gender | Female
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 149 HART ST 82 MEDICAL GROUP/CREDENTIALS
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City | SHEPPARD AFB
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State | TX
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Zip | 76311-3482
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Country | US
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Telephone | 940-676-4786
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 QUAIL VALLEY RD
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City | IOWA PARK
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State | TX
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Zip | 76367-3008
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Country | US
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Telephone | 940-592-0094
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 541232
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License Number State | TX
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