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NPI Code Detail

MEDICARE: MS. LINDA DIANE FOXWORTHY MSN,FNP

MEDICARE: MS. LINDA DIANE FOXWORTHY MSN,FNP
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
1363LF0000XFamily Nurse Practitioner158650MA

General Provider Information

NPI Number : 1376642272
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA DIANE FOXWORTHY MSN,FNP
Provider Business Mailing Address
First Line : 4 MERRIAM RD
Second Line :
City : GRAFTON
State : MA
Zip : 01519-1257
Country : US
Telephone Number : 508-839-4186
Fax Number :
Provider Business Practice Location Address
First Line : 3297 WASHINGTON ST
Second Line : BROOKSIDE HEALTH CENTER
City : JAMAICA PLAIN
State : MA
Zip : 02130-2655
Country : US
Telephone Number : 617-522-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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