Healthcare Provider Details

I. General information

NPI: 1841287653
Provider Name (Legal Business Name): LINDA CAROL HERSEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23140 MOAKLEY ST SUITE 4
LEONARDTOWN MD
20650-2930
US

IV. Provider business mailing address

5503 WOODRIDGE DR
WALDORF MD
20601-4301
US

V. Phone/Fax

Practice location:
  • Phone: 301-997-1029
  • Fax: 301-997-1489
Mailing address:
  • Phone: 301-932-9029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR038903
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR038903
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: