Provider Demographics
NPI:1447049168
Name:TALLEDO, LINDA (RNC-IBCLC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TALLEDO
Suffix:
Gender:
Credentials:RNC-IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7660
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29861-7660
Mailing Address - Country:US
Mailing Address - Phone:706-843-6241
Mailing Address - Fax:706-843-6242
Practice Address - Street 1:2100 CENTRAL AVE STE D1
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6709
Practice Address - Country:US
Practice Address - Phone:706-843-6241
Practice Address - Fax:706-843-6242
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN095775163WL0100X, 163WP0807X, 163WP0808X, 163WP0809X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult