Provider Demographics
NPI:1912068743
Name:BORUFF, LINDA DARNELL (MSN CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DARNELL
Last Name:BORUFF
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:YVONNE
Other - Last Name:DARNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2151 JAMIESON AVE
Mailing Address - Street 2:#1604
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5705
Mailing Address - Country:US
Mailing Address - Phone:717-823-0676
Mailing Address - Fax:
Practice Address - Street 1:1451 BELLE HAVEN RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-1201
Practice Address - Country:US
Practice Address - Phone:703-765-6093
Practice Address - Fax:703-765-7761
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704286251363LF0000X
PACRNP SP009277363LP0200X
VA0024158608363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA36007AOtherEPSDT PROVIDER NO.