Individual
MRS. LINDA B WATERWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1401 JOHNSTON WILLIS DR, SUITE 4500, RICHMOND, VA 23235-4730
(804) 320-1355
(804) 560-3531
Mailing address
1401 JOHNSTON WILLIS DR, SUITE 4500, RICHMOND, VA 23235-4730
(804) 320-1355
(804) 560-3531
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0001078920
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001078920
STATE LISCENSE
VA
Enumeration date
03/26/2007
Last updated
07/08/2007
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