Provider Demographics
NPI:1972949162
Name:CARROLL, LINDA ANNE (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:CARROLL
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 1:61 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4401
Mailing Address - Country:US
Mailing Address - Phone:732-776-4541
Mailing Address - Fax:732-776-4924
Practice Address - Street 1:61 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4401
Practice Address - Country:US
Practice Address - Phone:732-776-4281
Practice Address - Fax:732-776-4924
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07459100163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant