Provider Demographics
NPI:1164723193
Name:BRICKHOUSE, LINDA T (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:T
Last Name:BRICKHOUSE
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:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NC
Mailing Address - Zip Code:27925-0238
Mailing Address - Country:US
Mailing Address - Phone:252-793-1755
Mailing Address - Fax:252-766-3376
Practice Address - Street 1:408 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NC
Practice Address - Zip Code:27925
Practice Address - Country:US
Practice Address - Phone:252-793-1755
Practice Address - Fax:252-766-3376
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC158806163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse