Healthcare Provider Details

I. General information

NPI: 1679687107
Provider Name (Legal Business Name): LINDA BROWN SHELDON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NEW BERN AVE
RALEIGH NC
27610-1231
US

IV. Provider business mailing address

205 CARDINAL DR 205
YOUNGSVILLE NC
27596-9731
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8499
  • Fax:
Mailing address:
  • Phone: 919-349-0144
  • Fax: 919-761-9583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number072187
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number158444
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: