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General NPI Number Information
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NPI Number | 1609089481
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Entity Type | Individual
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Provider Name | LYNDA ELIZABETH BOCKMON ANP-BC, ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2101 MULBERRY AVE
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-1105
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Country | US
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Telephone | 903-434-4850
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Fax | 903-434-4899
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Provider Business Mailing Address
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Address Line | 1040 S FLEISHEL AVE
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City | TYLER
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State | TX
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Zip | 75701-2031
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Country | US
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Telephone | 903-533-8702
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP114362
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License Number State | TX
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