Provider Demographics
NPI:1295919058
Name:BRICKER, LINDA SUZANNE (RN)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUZANNE
Last Name:BRICKER
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 1:8732 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1101
Mailing Address - Country:US
Mailing Address - Phone:913-384-9778
Mailing Address - Fax:
Practice Address - Street 1:8732 W 69TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1101
Practice Address - Country:US
Practice Address - Phone:913-384-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-89620-062163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse