Provider Demographics
NPI:1083848428
Name:WINTRODE, LINDA ANN (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:WINTRODE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 WEST DR
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-8925
Mailing Address - Country:US
Mailing Address - Phone:831-251-5555
Mailing Address - Fax:
Practice Address - Street 1:382 WEST DR
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-8925
Practice Address - Country:US
Practice Address - Phone:831-251-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA634710163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management