MEDICARE: MS. LINDA ELLEN BRANZ N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	561904	TX

General Provider Information

NPI Number	:	1164551420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA ELLEN BRANZ N.P.

Provider Business Mailing Address
First Line	:	2801 LIVE OAK AVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-3205
Country	:	US
Telephone Number	:	254-757-0434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 PINE AVE
Second Line	:	SUITE 708
City	:	WACO
State	:	TX
Zip	:	76708-3247
Country	:	US
Telephone Number	:	254-754-0300
Fax Number	:	254-754-0301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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