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NPI Code Detail

MEDICARE: MRS. LINDA ANDERSEN RN

MEDICARE: MRS. LINDA ANDERSEN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0400XCase Management Registered Nurse4704168338MI

General Provider Information

NPI Number : 1184017105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA ANDERSEN RN
Provider Business Mailing Address
First Line : 1055 CHARTER DR
Second Line : SUITE 102
City : FLINT
State : MI
Zip : 48532-3589
Country : US
Telephone Number : 810-600-0000
Fax Number : 810-600-0002
Provider Business Practice Location Address
First Line : 1613 STAR BATT DR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-3706
Country : US
Telephone Number : 248-844-9650
Fax Number : 248-844-9651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2015
Last Update Date : 02/27/2017

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