Provider Demographics
NPI:1639471584
Name:WADUD, LINDA CAROL (BSN, MSN, CDE)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CAROL
Last Name:WADUD
Suffix:
Gender:F
Credentials:BSN, MSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:4E
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:6104 OLD BRANCH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748
Practice Address - Country:US
Practice Address - Phone:301-702-6390
Practice Address - Fax:301-702-6291
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR101340163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator