Provider Demographics
NPI:1639594138
Name:WANKERL, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WANKERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ONDOSSAGON CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3074
Mailing Address - Country:US
Mailing Address - Phone:608-576-0800
Mailing Address - Fax:608-827-9041
Practice Address - Street 1:6 ONDOSSAGON CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3074
Practice Address - Country:US
Practice Address - Phone:608-576-0800
Practice Address - Fax:608-827-9041
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator