Provider Demographics
NPI:1285631325
Name:CACI, LINDA (CRNA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CACI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:CACI-DIBERNARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 N HARRISON PKWY
Mailing Address - Street 2:#200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2853
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-514-2859
Practice Address - Street 1:60 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-0000
Practice Address - Country:US
Practice Address - Phone:978-466-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0414442311174400000X
MARN238977367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30342409Medicaid