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General NPI Number Information
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NPI Number | 1780394981
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Entity Type | Individual
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Provider Name | LINDA UDEANI
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Gender | Female
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 500 W 3RD AVE STE 105
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City | ALBANY
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State | GA
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Zip | 31701-1900
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Country | US
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Telephone | 229-312-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 3510 BROOKSEDGE WAY
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City | BUFORD
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State | GA
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Zip | 30519-5347
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Country | US
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Telephone | 614-507-8595
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN247383
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License Number State | GA
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