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General NPI Number Information
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NPI Number | 1629085576
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Entity Type | Individual
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Provider Name | LINDA LAVERNE OTTLEY NP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 632 BROADWAY PH
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City | NEW YORK
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State | NY
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Zip | 10012-2614
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Country | US
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Telephone | 800-731-4254
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Fax |
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Provider Business Mailing Address
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Address Line | 8472 VIA SONOMA UNIT 30
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City | LA JOLLA
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State | CA
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Zip | 92037-2735
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Country | US
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Telephone | 760-212-5172
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 8832
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP104217
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5647
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 14443
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R0132242
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2310658
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License Number State | MA
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11022481
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 8832
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP033398
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License Number State | PA
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R088414
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License Number State | MD
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN286333
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License Number State | GA
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 879334
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License Number State | NV
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