Provider Demographics
NPI:1407030166
Name:GORE, LINDA LEWIS (RRT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEWIS
Last Name:GORE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WHITBY CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5964
Mailing Address - Country:US
Mailing Address - Phone:919-272-0687
Mailing Address - Fax:
Practice Address - Street 1:103 WHITBY CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5964
Practice Address - Country:US
Practice Address - Phone:919-272-0687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA2757227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC561924070OtherTAX ID