Provider Demographics
NPI:1124895651
Name:LINDERMAN, AMANDA (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LINDERMAN
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 S LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2234
Mailing Address - Country:US
Mailing Address - Phone:336-287-8816
Mailing Address - Fax:
Practice Address - Street 1:5 W HARGETT ST RM 1012
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1377
Practice Address - Country:US
Practice Address - Phone:336-287-8816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC242624163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant