Healthcare Provider Details

I. General information

NPI: 1790937605
Provider Name (Legal Business Name): LINDA MCGRANE MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ SUITE 314
CAMDEN NJ
08103-1461
US

IV. Provider business mailing address

1 FEDERAL ST
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 856-963-6770
  • Fax:
Mailing address:
  • Phone: 856-356-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NR14838600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number26NR14838600
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number26NJ00727700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: