Provider Demographics
NPI:1205804218
Name:GADOURY, LINDA LEE (CNS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEE
Last Name:GADOURY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SHARPE ST
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-2100
Mailing Address - Country:US
Mailing Address - Phone:401-397-3750
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:THE MEADOWS BLDG D 305A
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-294-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN14971364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI22250-3OtherBLUE CROSS
RI406934OtherUNITED HEALTH CARE