MEDICARE: LINDA JOYCE ANDERSON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	302219	OH

General Provider Information

NPI Number	:	1427372309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA JOYCE ANDERSON RN

Provider Business Mailing Address
First Line	:	817 E 156TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3034
Country	:	US
Telephone Number	:	216-268-0192
Fax Number	:	216-268-0192

Provider Business Practice Location Address
First Line	:	817 E 156TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3034
Country	:	US
Telephone Number	:	216-268-0192
Fax Number	:	216-268-0192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2010
Last Update Date	:	03/21/2010

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