Provider Demographics
NPI:1851552061
Name:LINDA SHERMAN
Entity Type:Organization
Organization Name:LINDA SHERMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:WIKTORIA
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-801-6485
Mailing Address - Street 1:5207 EAGLE TRACE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-6403
Mailing Address - Country:US
Mailing Address - Phone:919-801-6485
Mailing Address - Fax:
Practice Address - Street 1:280 S BECKFORD DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2564
Practice Address - Country:US
Practice Address - Phone:919-801-6485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5268314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility