Linda Etheridge

Individual provider Active NPI Registered Nurse · Williston, FL

NPI 1982856449 · NPPES record last updated Oct 15, 2008

Key facts

NPI
1982856449
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN 1649222 (FL)
Practice address
15050 NE 20TH St
Williston, FL 32696-8846
Phone
(352) 538-7727
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN 1649222FLMDCase Management Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 1649222 FL Yes
Case Management Registered Nurse 163WC0400X RN 1649222 FL
Ambulatory Care Registered Nurse 163WP2201X RN 1649222 FL

Addresses

Primary practice location

15050 NE 20TH St
Williston, FL 32696-8846

Mailing address

15050 NE 20TH St
Williston, FL 32696-8846

Other providers in Williston, FL

All providers in Williston, FL · Registered Nurse in Florida

Sources for this page

Verify at the official NPI Registry.