Individual
MRS. LINDA RUTH SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
4600 N DAVIS HWY, PENSACOLA, FL 32503-2337
(850) 494-0065
(850) 494-0065
Mailing address
114 MEADOW RUN LOOP, FOLEY, AL 36535-9240
(251) 968-3826
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9175062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G2822
BCBS
FL
01
—
P00000521
MEDICARE RAILROAD
FL
Enumeration date
08/18/2006
Last updated
07/08/2007
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