Individual
LINDA PREBBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
260 SOUTH MAIN STREET, MAMMOTH SPRING, AR 72554
(807) 625-3228
(870) 625-3227
Mailing address
PO BOX 250, MAMMOTH SPRING, AR 72554-0250
(870) 625-3228
(870) 625-3227
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
655175
TX
363LF0000X
Family Nurse Practitioner
Primary
2010012214
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023053907
—
MO
01
—
431560263
TRICARE WEST
—
Enumeration date
06/17/2006
Last updated
08/06/2012
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