Healthcare Provider Details

I. General information

NPI: 1881737740
Provider Name (Legal Business Name): LINDA LEE GILLESPIE RN, MSN, COHN-SCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7014 BERRY BLOSSOM DR
CANFIELD OH
44406-8501
US

IV. Provider business mailing address

7014 BERRY BLOSSOM DR
CANFIELD OH
44406-8501
US

V. Phone/Fax

Practice location:
  • Phone: 330-702-8050
  • Fax: 330-702-8051
Mailing address:
  • Phone: 330-702-8050
  • Fax: 330-702-8051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN 218636
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: