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General NPI Number Information
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NPI Number | 1467489021
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Entity Type | Individual
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Provider Name | LINDA COCKRAM BAXTER RN PHD PMHNPCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 9097 ATLEE STATION RD SUITE 219
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2525
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Country | US
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Telephone | 804-730-2829
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Fax |
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Provider Business Mailing Address
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Address Line | 8518 CHESTER FOREST LN
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23237-2662
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Country | US
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Telephone | 804-221-5112
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024078127
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 0024078127
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License Number State | VA
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