Provider Demographics
NPI:1851389951
Name:EDDLESTON, LINDA E (PCNS BC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:E
Last Name:EDDLESTON
Suffix:
Gender:F
Credentials:PCNS BC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:TSCHIRLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LINDA TSCHIRLEY
Mailing Address - Street 1:38 REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5820
Mailing Address - Country:US
Mailing Address - Phone:401-374-1419
Mailing Address - Fax:
Practice Address - Street 1:38 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5820
Practice Address - Country:US
Practice Address - Phone:401-374-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN14202364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI74225OtherBCBS