Basic Information
| Provider Information | |||||||||
| NPI: | 1336468529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAGGARD | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | PEAVLEY | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | UK DIVISON OF PULMONARY | ||||||||
| Address2: | 740 S. LIMESTONE, L543 KY CLINIC | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593239555 | ||||||||
| FaxNumber: | 8592579286 | ||||||||
| Practice Location | |||||||||
| Address1: | UK DIVISON OF PULMONARY | ||||||||
| Address2: | 740 S. LIMESTONE, L543 KY CLINIC | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593239555 | ||||||||
| FaxNumber: | 8592579286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2010 | ||||||||
| LastUpdateDate: | 09/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 3006467 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | P00931548 | 01 | RAILROAD MEDICARE | OTHER | 000000681317 | 01 | KY | ANTHEM | OTHER | 7100140810 | 05 | KY | MEDICAID |