Provider Demographics
NPI:1386836468
Name:NELSON, LINDA ANN (NPP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HAMILTON AVENUE
Mailing Address - Street 2:CAYUGA HOME FOR CHILDREN
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021
Mailing Address - Country:US
Mailing Address - Phone:315-253-5383
Mailing Address - Fax:315-253-7278
Practice Address - Street 1:101 HAMILTON AVENUE
Practice Address - Street 2:CAYUGA HOME FOR CHILDREN
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021
Practice Address - Country:US
Practice Address - Phone:315-253-5383
Practice Address - Fax:315-253-7278
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health