Individual
LINDA RAE CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
841 N DOWNS ST, STE C, RIDGECREST, CA 93555-3361
(951) 234-4260
Mailing address
3337 W FLORIDA AVE, #159, HEMET, CA 92545-3513
(951) 234-4260
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363L00000X
—
CA
Enumeration date
02/18/2011
Last updated
02/18/2011
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