Healthcare Provider Details

I. General information

NPI: 1407764558
Provider Name (Legal Business Name): LINDA CHANGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 DRURY AVE
ATHOL MA
01331-2421
US

IV. Provider business mailing address

115 DRURY AVE
ATHOL MA
01331-2421
US

V. Phone/Fax

Practice location:
  • Phone: 978-397-2485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberLN1006002
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: