MEDICARE: GERALDINE ILENE LINDEN LPN

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	164W00000X	Licensed Practical Nurse	32387-031	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619178209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDINE ILENE LINDEN LPN

Provider Business Mailing Address
First Line	:	2316 DE KOVEN AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-2404
Country	:	US
Telephone Number	:	262-637-8841
Fax Number	:

Provider Business Practice Location Address
First Line	:	3107 67TH DR
Second Line	:
City	:	UNION GROVE
State	:	WI
Zip	:	53182-9445
Country	:	US
Telephone Number	:	262-878-3727
Fax Number	:

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	07/09/2007

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