Provider Demographics
NPI:1093053860
Name:ANYACHEBELU, LINDA (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ANYACHEBELU
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 1:4 BOBRICH DR
Mailing Address - Street 2:APT. A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-2034
Mailing Address - Country:US
Mailing Address - Phone:718-309-1708
Mailing Address - Fax:
Practice Address - Street 1:4 BOBRICH DR
Practice Address - Street 2:APT. A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-2034
Practice Address - Country:US
Practice Address - Phone:718-309-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY646382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse