Linda Prebble, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2010012214 Issued in MO

Practice address

260 South Main Street
Mammoth Spring, AR 72554

Phone

(807) 625-3228

Fax

(870) 625-3227

NPI assigned

Jun 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ozarks Medical Center

  • Rural Health Clinic/Center
  • Mammoth Spring, AR
  • NPI 1649306002
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1023053907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "MAMMOTH SPRING",
            "state": "AR",
            "postal_code": "725540250",
            "telephone_number": "870-625-3228",
            "fax_number": "870-625-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SOUTH MAIN STREET",
            "city": "MAMMOTH SPRING",
            "state": "AR",
            "postal_code": "72554",
            "telephone_number": "807-625-3228",
            "fax_number": "870-625-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBBLE",
        "first_name": "LINDA",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "655175",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010012214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023053907",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mental Health and Wellness on Main
• Justin Wade Montgomery, QBHP/CASE MANAGER
• Rosemary Catherine Murdie, QBHP
• Ozarks Medical Center
• Teresa A Powers, MHPP
• Elizabeth Puerta, CHW
• Candis Ring
• Ronald Myers
• Kimberly Simmons, QBHP
• Haley A Skaggs

• All providers in Mammoth Spring, AR
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.