Healthcare Provider Details

I. General information

NPI: 1518778927
Provider Name (Legal Business Name): LINDA MICHEEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 CRESCENT ST
SHENANDOAH IA
51601-1957
US

IV. Provider business mailing address

315 CRESCENT ST
SHENANDOAH IA
51601-1957
US

V. Phone/Fax

Practice location:
  • Phone: 712-242-5677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: