Provider Demographics
NPI:1316924079
Name:BOND, LINDA (FNP-BC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BOND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1729
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-1729
Mailing Address - Country:US
Mailing Address - Phone:601-545-8700
Mailing Address - Fax:601-582-5461
Practice Address - Street 1:100 HIGHWAY 535
Practice Address - Street 2:
Practice Address - City:SEMINARY
Practice Address - State:MS
Practice Address - Zip Code:39479-8809
Practice Address - Country:US
Practice Address - Phone:601-722-3208
Practice Address - Fax:601-722-3304
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR724564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS7946491OtherAETNA
MS11563865OtherCAQH ID NUMBER
MS00124977Medicaid
MS228529OtherUNITED HEALTH CARE
MS1719348P01OtherCIGNA
MS7946491OtherAETNA
MS500001285Medicare PIN