Provider Demographics
NPI:1033113873
Name:MACKLEER, LINDA M (CRNA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MACKLEER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 GILMAN RD
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1001
Mailing Address - Country:US
Mailing Address - Phone:215-542-0176
Mailing Address - Fax:
Practice Address - Street 1:246 WHEATSHEAF LN
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1551
Practice Address - Country:US
Practice Address - Phone:215-757-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN207095L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA855867Medicare ID - Type Unspecified