Provider Demographics
NPI:1124296850
Name:SKANE, LINDA MARIE (RN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:SKANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 CAMERON GLEN DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3363
Mailing Address - Country:US
Mailing Address - Phone:703-481-4174
Mailing Address - Fax:703-435-1961
Practice Address - Street 1:1850 CAMERON GLEN DR
Practice Address - Street 2:SUITE 600
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3363
Practice Address - Country:US
Practice Address - Phone:703-481-4174
Practice Address - Fax:703-435-1961
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001087773163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent