MEDICARE: LINDA HAWLEY LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1780216184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA HAWLEY LLC

Provider Business Mailing Address
First Line	:	1070 W HORIZON RIDGE PKWY STE 111
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-6019
Country	:	US
Telephone Number	:	702-683-3107
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	305 N PECOS RD STE F
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-1352
Country	:	US
Telephone Number	:	702-463-1665
Fax Number	:	702-463-3261

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	LINDA HAWLEY
Credential	:	APRN
Telephone Number	:	702-463-1665

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	04/15/2022

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