Provider Demographics
NPI:1982726444
Name:WEST, LINDA KAY (ANP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:WEST
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:KAY
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:706 S WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-5751
Mailing Address - Country:US
Mailing Address - Phone:479-715-8002
Mailing Address - Fax:501-708-2185
Practice Address - Street 1:706 S WALTON BLVD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5751
Practice Address - Country:US
Practice Address - Phone:479-715-8002
Practice Address - Fax:501-708-2185
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA001736363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5A414OtherBLUE CROSS BLUE SHIELD
AR166747758Medicaid
AR5A414OtherBLUE CROSS BLUE SHIELD