Linda Lee Prough, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

PN1228881 Issued in FL

Practice address

3905 Grissom Pkwy
Cocoa, FL 32926-3669

Phone

(321) 637-1866

Fax

(321) 637-1868

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124176573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 CANGRO ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329262227",
            "telephone_number": "321-639-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 GRISSOM PKWY",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329263669",
            "telephone_number": "321-637-1866",
            "fax_number": "321-637-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUGH",
        "first_name": "LINDA",
        "middle_name": "LEE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "FL",
            "license": "PN1228881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Licensed Vocational Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.