Provider Demographics
NPI:1821163940
Name:STALTERS, LINDA D (MSN, APRN, BC, PMH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:STALTERS
Suffix:
Gender:F
Credentials:MSN, APRN, BC, PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43490 MILLWRIGHT TER
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8466
Mailing Address - Country:US
Mailing Address - Phone:571-333-5386
Mailing Address - Fax:240-465-0667
Practice Address - Street 1:43490 MILLWRIGHT TER
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8466
Practice Address - Country:US
Practice Address - Phone:571-333-5386
Practice Address - Fax:240-465-0667
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC00393363LP0808X
VA0015000819363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health