Individual
LINDA R AANONSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1316 3RD AVE, CONWAY, SC 29526-5002
(843) 488-7283
Mailing address
2144 SPRING TREE DR, LITTLE RIVER, SC 29566-6542
(917) 816-3662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
012414
NY
363A00000X
Physician Assistant
Primary
4962
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02925648
—
NY
Enumeration date
07/05/2007
Last updated
02/01/2025
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