Provider Demographics
NPI:1316996424
Name:BILBO, LINDA SUE (APRN-BC-ANP-C)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:BILBO
Suffix:
Gender:F
Credentials:APRN-BC-ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 ANDREW AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39567-1802
Mailing Address - Country:US
Mailing Address - Phone:228-273-4096
Mailing Address - Fax:866-809-7246
Practice Address - Street 1:2810 ANDREW AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-1802
Practice Address - Country:US
Practice Address - Phone:228-273-4096
Practice Address - Fax:866-809-7246
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR532649363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00100351Medicaid
MS512I500127Medicare PIN
MSQ55979Medicare UPIN