Provider Demographics
NPI:1730613209
Name:CARDINAL, LINDA M (MS, RDN, LD, CDCES)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:CARDINAL
Suffix:
Gender:F
Credentials:MS, RDN, LD, CDCES
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:BIRKEMEIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RDN, LD, CDCES
Mailing Address - Street 1:737 DAYBREAK DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9858
Mailing Address - Country:US
Mailing Address - Phone:215-292-2364
Mailing Address - Fax:
Practice Address - Street 1:1111 RONALD REAGAN PKWY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7085
Practice Address - Country:US
Practice Address - Phone:215-292-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY146133V00000X
IN37004070A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered