Provider Demographics
NPI:1669055422
Name:DEMANOU, LINDA (FNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:DEMANOU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 ATHERTON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3031
Mailing Address - Country:US
Mailing Address - Phone:240-701-6437
Mailing Address - Fax:
Practice Address - Street 1:3637 MEDINA RD STE 85
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8153
Practice Address - Country:US
Practice Address - Phone:330-212-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145557363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner