Provider Demographics
NPI:1285929729
Name:DEFFINBAUGH, LINDA H
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:H
Last Name:DEFFINBAUGH
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 1:7305 MAPLECREST RD
Mailing Address - Street 2:#201
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6035
Mailing Address - Country:US
Mailing Address - Phone:410-796-1942
Mailing Address - Fax:
Practice Address - Street 1:7305 MAPLECREST RD
Practice Address - Street 2:#201
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6035
Practice Address - Country:US
Practice Address - Phone:410-796-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO65250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse