Provider Demographics
NPI:1649357930
Name:ANDERSON, LINDA J (WHNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-0626
Mailing Address - Country:US
Mailing Address - Phone:207-283-7333
Mailing Address - Fax:207-283-7850
Practice Address - Street 1:9 HEALTHCARE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9449
Practice Address - Country:US
Practice Address - Phone:207-282-4270
Practice Address - Fax:207-282-7350
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER014564363LW0102X
MEAP081723363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1649357930Medicaid
ME1649357930Medicaid