Provider Demographics
NPI:1275539868
Name:MCADAMS, LINDA BODLE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BODLE
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:LINDE
Other - Middle Name:BODLE
Other - Last Name:MCADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:1911 OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:DEMOPOLIS
Mailing Address - State:AL
Mailing Address - Zip Code:36732-3442
Mailing Address - Country:US
Mailing Address - Phone:334-289-3646
Mailing Address - Fax:334-289-5383
Practice Address - Street 1:203 HIGHWAY 80 WEST
Practice Address - Street 2:
Practice Address - City:DEMOPOLIS
Practice Address - State:AL
Practice Address - Zip Code:36732
Practice Address - Country:US
Practice Address - Phone:334-289-0526
Practice Address - Fax:334-289-5343
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1054912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily