Provider Demographics
NPI:1982995262
Name:DARBYSHIRE, LINDA LOUISE (APRN MSN BC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOUISE
Last Name:DARBYSHIRE
Suffix:
Gender:F
Credentials:APRN MSN BC
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:LOUISE
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:164 CRANVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2256
Mailing Address - Country:US
Mailing Address - Phone:508-240-7964
Mailing Address - Fax:360-462-5164
Practice Address - Street 1:PLEASANT LAKE MEDICAL CENTER
Practice Address - Street 2:253 PLEASANT LAKE AVE
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645
Practice Address - Country:US
Practice Address - Phone:508-945-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN184933364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110090975AMedicaid