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Individual

LINDA ETHERIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15050 NE 20TH ST, WILLISTON, FL 32696-8846
(352) 538-7727
Mailing address
15050 NE 20TH ST, WILLISTON, FL 32696-8846

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 1649222
FL
163WC0400X
Case Management Registered Nurse
RN 1649222
FL
163WP2201X
Ambulatory Care Registered Nurse
RN 1649222
FL

Other

Enumeration date
10/15/2008
Last updated
10/15/2008
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