Provider Demographics
NPI:1861274342
Name:WILLIS, LINDA F
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:WILLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:F
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAIDEN
Mailing Address - Street 1:9909 UNION AVENUE, CLEVELAND, OH, USA
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4723
Mailing Address - Country:US
Mailing Address - Phone:216-375-6577
Mailing Address - Fax:
Practice Address - Street 1:9909 UNION AVENUE, CLEVELAND, OH, USA
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-4723
Practice Address - Country:US
Practice Address - Phone:216-375-6577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health