Individual
LINDA G WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13100 E 136TH ST, STE 1200, FISHERS, IN 46037-9478
(317) 688-5200
(317) 688-5215
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71003450A
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
28132395A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201013900
—
IN
Enumeration date
10/14/2010
Last updated
11/25/2020
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