Basic Information
| Provider Information | |||||||||
| NPI: | 1437510765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCINTYRE | ||||||||
| FirstName: | LINDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 E CLINTON ST | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647352233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6603510995 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2846 WILLAMETTE ST | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974058200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412228700 | ||||||||
| FaxNumber: | 5412228701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2016 | ||||||||
| LastUpdateDate: | 09/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 201602597NP-PP | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 2016007859 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.