Provider Demographics
NPI:1982471181
Name:MASSINGALE, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MASSINGALE
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 1:4117 E 175TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-2223
Mailing Address - Country:US
Mailing Address - Phone:216-548-9530
Mailing Address - Fax:
Practice Address - Street 1:4117 E 175TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-2223
Practice Address - Country:US
Practice Address - Phone:216-548-9530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker