Provider Demographics
NPI:1023860004
Name:BLACKWOOD, LINDA EILEEN
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:EILEEN
Last Name:BLACKWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:EILEEN
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 E 266TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1912
Mailing Address - Country:US
Mailing Address - Phone:216-732-3098
Mailing Address - Fax:
Practice Address - Street 1:740 E 266TH ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1912
Practice Address - Country:US
Practice Address - Phone:216-732-3098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker