Provider Demographics
NPI:1720429145
Name:LINDEN, EVA (NP)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LINDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 VT RTE 107
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:VT
Mailing Address - Zip Code:05032-9107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1823 VT RTE 107
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:VT
Practice Address - Zip Code:05032-9107
Practice Address - Country:US
Practice Address - Phone:802-234-9913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-14
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6579981163W00000X
VT0260091569163W00000X
CT111696163W00000X
NY33 338593363LF0000X
VT101.0103365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse