Provider Demographics
NPI:1487955530
Name:DWYER, LINDA LEWIS (RN,CNS-PSYCH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEWIS
Last Name:DWYER
Suffix:
Gender:F
Credentials:RN,CNS-PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 EMERALD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-3643
Mailing Address - Country:US
Mailing Address - Phone:410-259-0703
Mailing Address - Fax:
Practice Address - Street 1:1210 EMERALD RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-3643
Practice Address - Country:US
Practice Address - Phone:410-259-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO45627364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult