Provider Demographics
NPI:1508456039
Name:ANDERS, LINDA MARIE (MBA, MSN, RN, CSRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:ANDERS
Suffix:
Gender:F
Credentials:MBA, MSN, RN, CSRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-3031
Mailing Address - Country:US
Mailing Address - Phone:630-200-4257
Mailing Address - Fax:
Practice Address - Street 1:2701 17TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5351
Practice Address - Country:US
Practice Address - Phone:309-779-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.383290163WC1500X
IA141261163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health