Provider Demographics
NPI:1659827335
Name:CARMELLINI, LINDA (NP-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CARMELLINI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 DAVID AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-6541
Mailing Address - Country:US
Mailing Address - Phone:440-477-1803
Mailing Address - Fax:
Practice Address - Street 1:2916 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3229
Practice Address - Country:US
Practice Address - Phone:216-535-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily