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General NPI Number Information
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NPI Number | 1881912558
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Entity Type | Individual
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Provider Name | MS. LINDA G NDUKA
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Gender | Female
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 6200 GLEN OAKS LN NE
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City | ATLANTA
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State | GA
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Zip | 30328-4197
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Country | US
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Telephone | 404-783-2144
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Fax |
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Provider Business Mailing Address
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Address Line | 2316 BLACKWATCH CIR SW
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City | MARIETTA
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State | GA
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Zip | 30008-6097
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Country | US
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Telephone | 404-783-2144
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Fax | 678-401-8945
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN041916
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License Number State | GA
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