Provider Demographics
NPI:1609002807
Name:WARREN, LINDA T (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:T
Last Name:WARREN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2715 HELEN ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-5805
Mailing Address - Country:US
Mailing Address - Phone:607-785-3807
Mailing Address - Fax:
Practice Address - Street 1:2715 HELEN ST
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-5805
Practice Address - Country:US
Practice Address - Phone:607-785-3807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261336163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse