Linda Marie Pedersen, MNARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30004070 Issued in IA

Practice address

600 Winslow Way E Ste 114
Bainbridge Island, WA 98110-3252

Phone

(206) 842-5979

Fax

(306) 842-4124

NPI assigned

Jan 10, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1164572590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WINSLOW WAY E STE 114",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103252",
            "telephone_number": "206-842-5979",
            "fax_number": "206-842-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WINSLOW WAY E STE 114",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103252",
            "telephone_number": "206-842-5979",
            "fax_number": "306-842-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MNARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "AP30004070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9649500",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.