Provider Demographics
NPI:1730056557
Name:BURCHAM, LINDA SUE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:BURCHAM
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 1:1538 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-2114
Mailing Address - Country:US
Mailing Address - Phone:740-646-2700
Mailing Address - Fax:
Practice Address - Street 1:1538 S 4TH ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2114
Practice Address - Country:US
Practice Address - Phone:740-646-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRF3838233747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider