Provider Demographics
NPI:1780951590
Name:KHALIL, LINDA JAYNE
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JAYNE
Last Name:KHALIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 TURNER DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1930
Mailing Address - Country:US
Mailing Address - Phone:585-617-2381
Mailing Address - Fax:585-352-9131
Practice Address - Street 1:43 TURNER DR
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1930
Practice Address - Country:US
Practice Address - Phone:585-617-2381
Practice Address - Fax:585-352-9131
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22362746163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse