Provider Demographics
NPI:1285236810
Name:MCCORD, LINDA DIANE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANE
Last Name:MCCORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 PEPPER RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26347-4708
Mailing Address - Country:US
Mailing Address - Phone:304-739-2552
Mailing Address - Fax:
Practice Address - Street 1:1770 PEPPER RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26347-4708
Practice Address - Country:US
Practice Address - Phone:304-739-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant