Provider Demographics
NPI:1417554486
Name:MEYER, LINDA
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:MEYER
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 1:910 COUNTY ROAD 32
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43469-9767
Mailing Address - Country:US
Mailing Address - Phone:419-356-5081
Mailing Address - Fax:
Practice Address - Street 1:910 COUNTY ROAD 32
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:OH
Practice Address - Zip Code:43469-9767
Practice Address - Country:US
Practice Address - Phone:419-356-5081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 376J00000X
OH6200417373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist