Provider Demographics
NPI:1972575975
Name:STOVER, LINDA C (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:STOVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLLEGE DRIVE URGENT CARE, LLC
Mailing Address - Street 2:WY-4140A LARAMIE ST.
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1969
Mailing Address - Country:US
Mailing Address - Phone:480-353-2210
Mailing Address - Fax:
Practice Address - Street 1:914 N SCOTTSDALE RD STE 104
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-2116
Practice Address - Country:US
Practice Address - Phone:480-924-8382
Practice Address - Fax:480-966-0566
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN104862163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1972575975OtherNATIONAL NPI
AZ456336Medicaid
AZS68485Medicare UPIN