Provider Demographics
NPI:1366532731
Name:EDGAR, LINDA VIRA-LELAND (RN WOCN)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:VIRA-LELAND
Last Name:EDGAR
Suffix:
Gender:F
Credentials:RN WOCN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5901 E. 7TH STREET
Mailing Address - Street 2:08/118
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90822
Mailing Address - Country:US
Mailing Address - Phone:562-826-5310
Mailing Address - Fax:562-826-5662
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:08/118
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-5310
Practice Address - Fax:562-826-5662
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA256604163WE0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy