Provider Demographics
NPI:1912149113
Name:ANDERSON, LINDA (RNFA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PAT ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7261
Mailing Address - Country:US
Mailing Address - Phone:207-649-6144
Mailing Address - Fax:
Practice Address - Street 1:31 PAT ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-7261
Practice Address - Country:US
Practice Address - Phone:207-649-6144
Practice Address - Fax:888-329-6432
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER027754163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant