=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841287653
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDA CAROL HERSEY NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2005
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23140 MOAKLEY ST SUITE 4
-----------------------------------------------------
City | LEONARDTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20650-2930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-997-1029
-----------------------------------------------------
Fax | 301-997-1489
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5503 WOODRIDGE DR
-----------------------------------------------------
City | WALDORF
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20601-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-932-9029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | R038903
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LX0001X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
-----------------------------------------------------
License Number | R038903
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------