Provider Demographics
NPI:1942201827
Name:FALLON, LINDA B (RNNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:FALLON
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WOBURN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2907
Mailing Address - Country:US
Mailing Address - Phone:781-944-4250
Mailing Address - Fax:781-944-4250
Practice Address - Street 1:107 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2907
Practice Address - Country:US
Practice Address - Phone:781-944-4250
Practice Address - Fax:781-944-4250
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199584163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABE NP2776Medicare ID - Type Unspecified