Provider Demographics
NPI:1174854269
Name:WERNER, LINDA JEAN (LPN)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:JEAN
Last Name:WERNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OLD TURNPIKE ROAD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954
Mailing Address - Country:US
Mailing Address - Phone:845-624-0260
Mailing Address - Fax:845-624-0264
Practice Address - Street 1:20 OLD TURNPIKE ROAD
Practice Address - Street 2:SUITE #105
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954
Practice Address - Country:US
Practice Address - Phone:845-624-0260
Practice Address - Fax:845-624-0264
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179945-1LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse