Provider Demographics
NPI:1710408208
Name:MOHR, LINDA C (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:MOHR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:C
Other - Last Name:HESSONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 412047
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2047
Mailing Address - Country:US
Mailing Address - Phone:301-790-9044
Mailing Address - Fax:301-790-9096
Practice Address - Street 1:11116 MEDICAL CAMPUS RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6710
Practice Address - Country:US
Practice Address - Phone:301-790-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018218363LA2100X
MDR149344363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
14146155OtherCAQH