Provider Demographics
NPI:1821215864
Name:LINEBERRY, STERLYN E (LPN)
Entity Type:Individual
Prefix:MR
First Name:STERLYN
Middle Name:E
Last Name:LINEBERRY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PAINTER ST
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-3828
Mailing Address - Country:US
Mailing Address - Phone:276-236-2994
Mailing Address - Fax:276-238-8762
Practice Address - Street 1:112 PAINTER ST
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-3828
Practice Address - Country:US
Practice Address - Phone:276-236-2994
Practice Address - Fax:276-238-8762
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002032697164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse