Provider Demographics
NPI:1194168922
Name:BARTLETT, LINDA CAROLINE (FNP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CAROLINE
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:CAROLINE
Other - Last Name:FREWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 GIFFORD ST
Mailing Address - Street 2:FAMILY MEDICINE
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-3201
Mailing Address - Country:US
Mailing Address - Phone:315-703-2600
Mailing Address - Fax:
Practice Address - Street 1:321 GIFFORD ST
Practice Address - Street 2:FAMILY MEDICINE
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3201
Practice Address - Country:US
Practice Address - Phone:315-703-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337362-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400090342Medicare PIN