Provider Demographics
NPI:1366528432
Name:EARHART, LINDA AMICK I
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:AMICK
Last Name:EARHART
Suffix:I
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 1:400 PARVIEW PL
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7469
Mailing Address - Country:US
Mailing Address - Phone:804-266-8182
Mailing Address - Fax:
Practice Address - Street 1:MCGUIRE VETERANS MEDICAL CTR
Practice Address - Street 2:1201 BROAD ROCK BLVD
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024070716363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health