Provider Demographics
NPI:1477813715
Name:CALDWELL, LINDA A (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:A
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:28000 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2468
Mailing Address - Country:US
Mailing Address - Phone:586-753-0930
Mailing Address - Fax:586-753-0931
Practice Address - Street 1:28000 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2468
Practice Address - Country:US
Practice Address - Phone:586-753-0930
Practice Address - Fax:586-753-0931
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI00145625163WC0400X
MI21120064163WD0400X
MI4704110633163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator