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General NPI Number Information
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NPI Number | 1952883571
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Entity Type | Individual
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Provider Name | ANA LINDA LABORDE AGNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 219 S WOODDALE AVE
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City | EAGLE
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State | ID
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Zip | 83616-7714
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Country | US
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Telephone | 208-994-5575
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Fax | 208-994-5576
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Provider Business Mailing Address
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Address Line | PO BOX 1278
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City | EAGLE
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State | ID
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Zip | 83616-1278
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Country | US
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Telephone | 89-945-5752
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Fax | 208-994-5576
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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 | 730989
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 730989
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 59811
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 59811
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License Number State | ID
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