Provider Demographics
NPI:1962770198
Name:FROST, LINDA L (LE, LLCC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:L
Last Name:FROST
Suffix:
Gender:F
Credentials:LE, LLCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6890 E SUNRISE DR #120
Mailing Address - Street 2:PMB 472
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-0739
Mailing Address - Country:US
Mailing Address - Phone:520-400-6763
Mailing Address - Fax:
Practice Address - Street 1:1601 N TUCSON BLVD STE 37
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3410
Practice Address - Country:US
Practice Address - Phone:520-400-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ271303347374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician