MEDICARE: LINDA UDEANI

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN247383	GA

General Provider Information

NPI Number	:	1780394981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA UDEANI

Provider Business Mailing Address
First Line	:	3510 BROOKSEDGE WAY
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-5347
Country	:	US
Telephone Number	:	614-507-8595
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W 3RD AVE STE 105
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-1900
Country	:	US
Telephone Number	:	229-312-7001
Fax Number	:

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

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	12/05/2025

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Directions to “ LINDA UDEANI ” Practice Location

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