MEDICARE: LINDA ADEDURO NP

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	363LF0000X	Family Nurse Practitioner	95006357	CA

General Provider Information

NPI Number	:	1639604192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ADEDURO NP

Provider Business Mailing Address
First Line	:	15571 LUCKY PL
Second Line	:
City	:	SYLMAR
State	:	CA
Zip	:	91342-3570
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 E RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6315
Country	:	US
Telephone Number	:	310-292-7982
Fax Number	:

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

Provider Enumeration Date	:	04/21/2017
Last Update Date	:	12/08/2021

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Directions to “ LINDA ADEDURO NP” Practice Location

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