Provider Demographics
NPI:1407848583
Name:CALDWELL, LINDA MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-1400
Mailing Address - Country:US
Mailing Address - Phone:781-925-1113
Mailing Address - Fax:
Practice Address - Street 1:759 GRANITE ST
Practice Address - Street 2:SOUTH SHORE HEALTH CENTER
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5328
Practice Address - Country:US
Practice Address - Phone:781-848-1950
Practice Address - Fax:781-356-4887
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103229363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP2790OtherBCBS
MA0700827Medicaid
NP2790Medicare ID - Type Unspecified
MA0700827Medicaid