Provider Demographics
NPI:1699263350
Name:JAMES, LINDA K
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:JAMES
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 1:6509 N STEVENS HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8548
Mailing Address - Country:US
Mailing Address - Phone:804-439-7347
Mailing Address - Fax:804-276-1215
Practice Address - Street 1:6509 N STEVENS HOLLOW DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8548
Practice Address - Country:US
Practice Address - Phone:804-439-7347
Practice Address - Fax:804-276-1215
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0176920202Medicaid