Lynda R Formosa (NPI# 1477665172, PAC ID# 6800973694) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1477665172 |
| PAC ID by PECOS | 6800973694 |
| Professional Enrollment ID | I20191029002975 |
| Full Name | Lynda R Formosa |
| Organization Legal Name | SAFE HARBOR CLINIC LLC |
| Address |
4013 Beatline Rd Suite A Long Beach MS 39560-4135 |
| Phone Number | 2282000720 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1759615693 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4013 Beatline Rd, Suite A, Long Beach, MS 39560-4135 | 2282000720 | SAFE HARBOR CLINIC LLC |
| Organization Legal Name | SAFE HARBOR CLINIC LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Ann Nelson | Clinical Social Worker | Safe Harbor Clinic LLC | 4013 Beatline Rd, Suite A, Long Beach, MS 39560-4135 |
| Street Address |
4013 BEATLINE RD SUITE A |
| City | LONG BEACH |
| State | MS |
| Zip | 39560-4135 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Ann Nelson | Clinical Social Worker | Safe Harbor Clinic LLC | 4013 Beatline Rd, Suite A, Long Beach, MS 39560-4135 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David L Reeves | Pediatric Medicine | Memorial Hospital At Gulfport | 20091 Pineville Rd, Long Beach, MS 39560-3208 |
| Valerie R Lenox | Internal Medicine | Memorial Hospital At Gulfport | 5120 Beatline Rd, Suite B, Long Beach, MS 39560-3815 |
| Betty D Edrington | Nurse Practitioner | Memorial Hospital At Gulfport | 5120 Beatline Rd, Long Beach, MS 39560-3815 |
| Nancy C Montz | Internal Medicine | Memorial Hospital At Gulfport | 5120 Beatline Rd, Long Beach, MS 39560-3815 |
| Thomas L Graves | Emergency Medicine | Memorial Hospital At Gulfport | 5120 Beatline Rd, Suite B, Long Beach, MS 39560-3815 |
| Melissa Tucker | Family Medicine | Memorial Hospital At Gulfport | 5120 Beatline Rd, Suite B, Long Beach, MS 39560-3815 |
| Cristina Rupp | Nurse Practitioner | Memorial Hospital At Gulfport | 5120 Beatline Rd, Long Beach, MS 39560-3815 |
| George Ward | Family Medicine | Memorial Hospital At Gulfport | 5120 Beatline Rd, Long Beach, MS 39560-3815 |
| James M Ryan | Nurse Practitioner | Memorial Hospital At Gulfport | 5120 Beatline Rd, Suite B, Long Beach, MS 39560-3815 |
| Douglas L Bates | Physical Therapy | Encore Rehabilitation Inc | 5107 Beatline Rd, Suite 300, Long Beach, MS 39560-3874 |
| Find all physicians in zip 39560 | |||
| City | LONG BEACH |
| Zip Code | 39560 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LONG BEACH + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Lynda R Formosa.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.