MEDICARE: MRS. LINDA KAREN GIBBONS ARNP

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	363LF0000X	Family Nurse Practitioner	ARNP 3092282	FL

General Provider Information

NPI Number	:	1982616918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA KAREN GIBBONS ARNP

Provider Business Mailing Address
First Line	:	11975 6TH ST E
Second Line	:
City	:	TREASURE ISLAND
State	:	FL
Zip	:	33706-2927
Country	:	US
Telephone Number	:	727-360-1822
Fax Number	:	727-398-9568

Provider Business Practice Location Address
First Line	:	11975 6TH ST E.
Second Line	:
City	:	TREASURE ISLAND
State	:	FL
Zip	:	33706-2927
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:	727-398-9568

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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