Provider Demographics
NPI:1619142981
Name:CORNA, LINDA SUE (LPN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:CORNA
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 1:5005 SHADY OAK DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9351
Mailing Address - Country:US
Mailing Address - Phone:614-850-9861
Mailing Address - Fax:
Practice Address - Street 1:5005 SHADY OAK DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9351
Practice Address - Country:US
Practice Address - Phone:614-850-9861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH028990164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse