Provider Demographics
NPI:1841468253
Name:SMITH, LINDA G (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:G
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHARLES DR APT I4
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2411
Mailing Address - Country:US
Mailing Address - Phone:267-970-7244
Mailing Address - Fax:
Practice Address - Street 1:100 CHARLES DR
Practice Address - Street 2:APT I-4
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2411
Practice Address - Country:US
Practice Address - Phone:267-970-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP006733C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner