Individual
MRS. LINDA JEAN WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1309 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 933-3212
(704) 933-3221
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2806998A
MEDICARE
NC
05
—
6005033
—
NC
Enumeration date
07/31/2006
Last updated
05/08/2017
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