Provider Demographics
NPI:1821376575
Name:MEDEIROS, LINDA (LPN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:MEDEIROS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 QUARRY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1025
Mailing Address - Country:US
Mailing Address - Phone:508-679-8111
Mailing Address - Fax:774-888-0042
Practice Address - Street 1:387 QUARRY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1025
Practice Address - Country:US
Practice Address - Phone:508-679-8111
Practice Address - Fax:774-888-0042
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN59604164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse