Provider Demographics
NPI:1063819522
Name:LINTON, DELORIS YVONNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DELORIS
Middle Name:YVONNE
Last Name:LINTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:DELORIS
Other - Middle Name:YVONNE
Other - Last Name:LINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:13 WIGGIN AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1600
Mailing Address - Country:US
Mailing Address - Phone:617-519-5744
Mailing Address - Fax:781-326-3461
Practice Address - Street 1:13 WIGGIN AVE
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1600
Practice Address - Country:US
Practice Address - Phone:617-519-5744
Practice Address - Fax:781-326-3461
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN92308164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse