Provider Demographics
NPI:1497816755
Name:HEALY, LINDA (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HEALY
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 1:23388 MULHOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2733
Mailing Address - Country:US
Mailing Address - Phone:818-876-1636
Mailing Address - Fax:818-876-1516
Practice Address - Street 1:23388 MULHOLLAND DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2733
Practice Address - Country:US
Practice Address - Phone:818-876-1636
Practice Address - Fax:818-876-1516
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9119363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP9119AMedicare ID - Type Unspecified
CAWNP9119EMedicare ID - Type Unspecified
CAWNP9119CMedicare ID - Type Unspecified
CAWNP9119BMedicare ID - Type Unspecified
CAP17990Medicare UPIN
CAWNP9119DMedicare ID - Type Unspecified