Basic Information
| Provider Information | |||||||||
| NPI: | 1346825775 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANN | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15235 SW 152ND CT | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331875430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862340096 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1205 4TH ST | ||||||||
| Address2: | |||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330403707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | 3052926723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2021 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | APRN11012051 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.