Provider Demographics
NPI:1548252760
Name:PAUL, LINDA M (APRN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:PAUL
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:RAY MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CPNP-PC
Mailing Address - Street 1:5213 FIELDCREST AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2479
Mailing Address - Country:US
Mailing Address - Phone:318-446-0303
Mailing Address - Fax:
Practice Address - Street 1:3330 MASONIC DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3841
Practice Address - Country:US
Practice Address - Phone:318-446-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA050976 APO3468363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA43088Medicaid