MEDICARE: LINDA ANNE GRACE RN, BS

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
1	163WA2000X	Administrator Registered Nurse	328667	CA
2	163WH0200X	Home Health Registered Nurse	328667	CA
3	163WH1000X	Hospice Registered Nurse	328667	CA
4	163WI0500X	Infusion Therapy Registered Nurse	328667	CA
5	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	328667	CA
6	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	328667	CA
7	163WP0808X	Psychiatric/Mental Health Registered Nurse	328667	CA

General Provider Information

NPI Number	:	1356071666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ANNE GRACE RN, BS

Provider Business Mailing Address
First Line	:	7876 RIVERSIDE DR
Second Line	:
City	:	PARKER
State	:	AZ
Zip	:	85344-7201
Country	:	US
Telephone Number	:	714-681-3999
Fax Number	:	714-755-3648

Provider Business Practice Location Address
First Line	:	10507 GARDEN GROVE BLVD
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1128
Country	:	US
Telephone Number	:	714-689-2300
Fax Number	:	714-689-2301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	11/12/2022

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Directions to “ LINDA ANNE GRACE RN, BS” Practice Location

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