Basic Information
| Provider Information | |||||||||
| NPI: | 1558338459 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDER | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 ALPINE CIRCLE | ||||||||
| Address2: | |||||||||
| City: | COLA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037793548 | ||||||||
| FaxNumber: | 8037797055 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 ALPINE CIRCLE | ||||||||
| Address2: | |||||||||
| City: | COLA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037793548 | ||||||||
| FaxNumber: | 8037797055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 09/26/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 27075 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | NP0500 | 05 | SC | MEDICAID |