Provider Demographics
NPI:1568059525
Name:SACHSDEBOLD, LINDA C (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:SACHSDEBOLD
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 1:24 SOPHIE DR
Mailing Address - Street 2:
Mailing Address - City:DARDENNE PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7580
Mailing Address - Country:US
Mailing Address - Phone:314-605-3946
Mailing Address - Fax:
Practice Address - Street 1:24 SOPHIE DR
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368-7580
Practice Address - Country:US
Practice Address - Phone:314-605-3946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015007708163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty