MEDICARE: MS. LINDA M. ABRAHAM CNM

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	367A00000X	Advanced Practice Midwife	RN178502	GA

General Provider Information

NPI Number	:	1467456210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA M. ABRAHAM CNM

Provider Business Mailing Address
First Line	:	3125 KENSINGTON RD
Second Line	:
City	:	AVONDALE ESTATES
State	:	GA
Zip	:	30002-1454
Country	:	US
Telephone Number	:	404-462-4949
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 KENSINGTON RD
Second Line	:
City	:	AVONDALE ESTATES
State	:	GA
Zip	:	30002-1454
Country	:	US
Telephone Number	:	404-462-4949
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	05/22/2012

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