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General NPI Number Information
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NPI Number | 1396951133
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Entity Type | Individual
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Provider Name | LINDA LOUISE WARDACH R.N.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1270 DORIS RD
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City | AUBURN HILLS
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State | MI
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Zip | 48326-2617
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Country | US
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Telephone | 248-276-8000
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Fax | 248-276-8009
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Provider Business Mailing Address
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Address Line | 4067 ELMHURST RD
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City | WATERFORD
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State | MI
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Zip | 48328-4026
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Country | US
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Telephone | 248-683-2186
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4704161482
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License Number State | MI
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