Provider Demographics
NPI:1427372309
Name:ANDERSON, LINDA JOYCE (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JOYCE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 E 156TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3034
Mailing Address - Country:US
Mailing Address - Phone:216-268-0192
Mailing Address - Fax:216-268-0192
Practice Address - Street 1:817 E 156TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3034
Practice Address - Country:US
Practice Address - Phone:216-268-0192
Practice Address - Fax:216-268-0192
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH302219163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse