MEDICARE: LINDA JEAN LETHERMAN

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	183500000X	Pharmacist	26014339A	IN

General Provider Information

NPI Number	:	1447847959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA JEAN LETHERMAN

Provider Business Mailing Address
First Line	:	242 N OAKLAND AVE
Second Line	:
City	:	NAPPANEE
State	:	IN
Zip	:	46550-2319
Country	:	US
Telephone Number	:	574-773-7873
Fax Number	:	574-773-3673

Provider Business Practice Location Address
First Line	:	242 N OAKLAND AVE
Second Line	:
City	:	NAPPANEE
State	:	IN
Zip	:	46550-2319
Country	:	US
Telephone Number	:	574-773-7873
Fax Number	:	574-773-3673

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

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	12/30/2020

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Directions to “ LINDA JEAN LETHERMAN ” Practice Location

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