Provider Demographics
NPI:1871747782
Name:STANLEY, LINDA JANELLE (RN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JANELLE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:JANELLE
Other - Last Name:WEISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1026 50TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2724
Mailing Address - Country:US
Mailing Address - Phone:727-368-6542
Mailing Address - Fax:727-368-6542
Practice Address - Street 1:1026 50TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2724
Practice Address - Country:US
Practice Address - Phone:727-368-6542
Practice Address - Fax:727-368-6542
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV61652163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse