Provider Demographics
NPI:1588843387
Name:CREDIT, LINDA STRAWHAND (LPN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:STRAWHAND
Last Name:CREDIT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BROOKTREE TER
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8923
Mailing Address - Country:US
Mailing Address - Phone:315-986-7347
Mailing Address - Fax:
Practice Address - Street 1:3 BROOKTREE TER
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8923
Practice Address - Country:US
Practice Address - Phone:315-986-7347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156405-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse