Provider Demographics
NPI:1093027237
Name:SWEENEY, LINDA SUSAN (LPN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUSAN
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:SUSAN
Other - Last Name:GELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1656 N JERRIE BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3467
Mailing Address - Country:US
Mailing Address - Phone:520-401-4600
Mailing Address - Fax:
Practice Address - Street 1:1656 N JERRIE BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3467
Practice Address - Country:US
Practice Address - Phone:520-401-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTLP046411164W00000X
NY106106-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse