Provider Demographics
NPI:1114222684
Name:SUTTON, LINDA HOOVER (RN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:HOOVER
Last Name:SUTTON
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 1:5522 HAMPTON OAK PL
Mailing Address - Street 2:BLDG A
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-8122
Mailing Address - Country:US
Mailing Address - Phone:850-566-2421
Mailing Address - Fax:
Practice Address - Street 1:5522 HAMPTON OAK PL
Practice Address - Street 2:BLDG A
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-8122
Practice Address - Country:US
Practice Address - Phone:850-566-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1363223747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00308400Medicaid