Healthcare Provider Details

I. General information

NPI: 1427374735
Provider Name (Legal Business Name): LINDA GAREA ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512-4226
US

IV. Provider business mailing address

1011 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512-4226
US

V. Phone/Fax

Practice location:
  • Phone: 330-629-2888
  • Fax: 330-629-8940
Mailing address:
  • Phone: 330-629-2888
  • Fax: 330-629-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberCOA.11376-NS
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.145553-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: