Provider Demographics
NPI:1144275231
Name:COREY, LINDA ANN (RN NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:COREY
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:91 MONTVALE AVE
Mailing Address - Street 2:DHA ENDOSCOPY LLC
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3623
Mailing Address - Country:US
Mailing Address - Phone:781-665-3380
Mailing Address - Fax:
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 306
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-665-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA150908363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3656OtherBLUE CROSS & BLUE SHIELD
MAP48445Medicare UPIN