Healthcare Provider Details

I. General information

NPI: 1740306984
Provider Name (Legal Business Name): LINDA MARIE SELLS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HWY
DOWNEY CA
90242
US

IV. Provider business mailing address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

V. Phone/Fax

Practice location:
  • Phone: 562-657-9960
  • Fax:
Mailing address:
  • Phone: 562-657-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA2519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: