Healthcare Provider Details

I. General information

NPI: 1518943034
Provider Name (Legal Business Name): LINNA M ROGERS-SALTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 BERRYHILL RD
MILTON FL
32570-5062
US

IV. Provider business mailing address

2979 GREYSTONE DR
PACE FL
32571-8453
US

V. Phone/Fax

Practice location:
  • Phone: 850-626-5013
  • Fax: 850-626-5256
Mailing address:
  • Phone: 850-995-1193
  • Fax: 850-995-1193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1660582
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: