Provider Demographics
NPI:1982017752
Name:SHIVER, LINDA LANE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LANE
Last Name:SHIVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LANE
Other - Last Name:PAGANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:626 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8829
Mailing Address - Country:US
Mailing Address - Phone:706-660-1177
Mailing Address - Fax:706-660-1098
Practice Address - Street 1:626 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8829
Practice Address - Country:US
Practice Address - Phone:706-660-1177
Practice Address - Fax:706-660-1098
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN172490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily