Healthcare Provider Details

I. General information

NPI: 1649357930
Provider Name (Legal Business Name): LINDA J ANDERSON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HEALTHCARE DR SUITE 101
BIDDEFORD ME
04005-9449
US

IV. Provider business mailing address

PO BOX 626
BIDDEFORD ME
04005-0626
US

V. Phone/Fax

Practice location:
  • Phone: 207-282-4270
  • Fax: 207-282-7350
Mailing address:
  • Phone: 207-283-7333
  • Fax: 207-283-7850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR014564
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP081723
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: