LINDA LOU TISDALE (NPI# 1215059829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215059829 |
| Entity Type | Individual |
| Full Name | LINDA LOU TISDALE |
| Other Name | LINDA LOU LEAKE |
| Credential | ARNP |
| Practice Address |
1760 Edgewood Ave W Jacksonville FL 32208-7209 |
| Mailing Address |
215 E 6th St Jacksonville FL 32206-4505 |
| Practice Telephone | 9043014900 |
| Practice Fax Number | 9049241773 |
| Mailing Telephone | 9043561630 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9220367 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1760 EDGEWOOD AVE W |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-7209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568426302 | Willie A Pennick | Family Medicine | 1760 Edgewood Ave W, Suite B, Jacksonville, FL 32208-7209 | 2006-04-17 |
| 1720444557 | Elite Ankle and Foot LLC | Podiatrist | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2016-01-09 |
| 1699020446 | Fl Department of Health | Public Health or Welfare | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2012-07-18 |
| 1205109410 | Danna Charlene Morris | Nurse Practitioner | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2012-02-17 |
| 1730402975 | Dedrick Michelle Daniels | Podiatrist | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2010-03-02 |
| 1861661506 | Doris Marie Chance | Physician Assistant | 1760 Edgewood Ave W, B, Jacksonville, FL 32208-7209 | 2008-02-27 |
| 1013006691 | Maria Susan Martinez | Social Worker | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-10-12 |
| 1851345714 | Kenneth E Nixon | Family Medicine | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-05-22 |
| 1811941677 | James L Gentry | Pediatrics | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-05-19 |
| 1194789958 | Pennic, Wooten& Associates Family Medical Care Pa | Family Medicine | 1760 Edgewood Ave W, B, Jacksonville, FL 32208-7209 | 2006-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293868 | Maria Fe Guboc Rufano-sulit | Nurse Practitioner | 3682 Summerlin Ln, Jacksonville, FL 32224-1650 | 2020-10-21 |
| 1346849502 | Caitlin Flott | Nurse Practitioner | 14589 Camberwell Ln S, Jacksonville, FL 32258-1708 | 2020-10-20 |
| 1972101137 | Amanda Brooke Mills | Nurse Practitioner | 8459 Oak Crossing Dr W, Jacksonville, FL 32244-6949 | 2020-10-10 |
| 1649877200 | Shalom Barile | Nurse Practitioner | 1377 Ingleside Ave, Jacksonville, FL 32205-7733 | 2020-10-07 |
| 1013524248 | Claudia Joseph | Nurse Practitioner | 3331 Net Ct, Jacksonville, FL 32277-2735 | 2020-10-01 |
| 1063029577 | Erica Francisca Andrade | Nurse Practitioner | 5475 Turkey Creek Rd, Jacksonville, FL 32244-8549 | 2020-09-29 |
| 1568078418 | Jennifer Ruth Woodard | Nurse Practitioner | 29 Trinity Way, Jacksonville, AL 36265-5813 | 2020-09-16 |
| 1013522309 | William David Michal | Nurse Practitioner | 4417 Chippewa Dr, Jacksonville, FL 32210-6006 | 2020-09-13 |
| 1063025906 | Fabiola Baptiste | Nurse Practitioner | 9143 Philips Hwy Ste 110, Jacksonville, FL 32256-1365 | 2020-08-29 |
| 1295348464 | Debi Cohen | Nurse Practitioner | 11266 Cloverhill Ct, Jacksonville, FL 32257-1438 | 2020-08-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
Please comment or provide details below to improve the information on LINDA LOU TISDALE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.