Provider Demographics
NPI:1427586569
Name:SELLERS, LINDA LYNN
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LYNN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854-3206
Mailing Address - Country:US
Mailing Address - Phone:334-768-2110
Mailing Address - Fax:334-768-2112
Practice Address - Street 1:3501 20TH AVE
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854-3206
Practice Address - Country:US
Practice Address - Phone:334-768-2110
Practice Address - Fax:334-768-2112
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL07361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist