Provider Demographics
NPI:1881819662
Name:JOSEPHSON, LINDA O (RN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:O
Last Name:JOSEPHSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:SHADY SIDE
Mailing Address - State:MD
Mailing Address - Zip Code:20764-9666
Mailing Address - Country:US
Mailing Address - Phone:410-867-2612
Mailing Address - Fax:
Practice Address - Street 1:1 HARRY S TRUMAN PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7042
Practice Address - Country:US
Practice Address - Phone:410-222-4499
Practice Address - Fax:410-222-4067
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127749163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health