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General NPI Number Information
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NPI Number | 1760675953
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Entity Type | Individual
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Provider Name | LINDA LAVERNE KEDDINGTON APRN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 315 5TH AVE
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City | FAIRBANKS
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State | AK
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Zip | 99701-5025
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Country | US
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Telephone | 406-579-7101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58621
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City | FAIRBANKS
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State | AK
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Zip | 99711-0621
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Country | US
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Telephone | 406-579-7101
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 30177
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0992259-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1373
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License Number State | AK
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Taxonomy #4
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 201811259NP-PP
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License Number State | OR
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