Healthcare Provider Details

I. General information

NPI: 1518047356
Provider Name (Legal Business Name): LINDA L ROBARDS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLAY MEDICAL CENTER 201 E N AVENUE
FLORA IL
62839
US

IV. Provider business mailing address

REA CLINIC PO BOX 155
CHRISTOPHER IL
62822
US

V. Phone/Fax

Practice location:
  • Phone: 618-662-8386
  • Fax: 618-662-4338
Mailing address:
  • Phone: 618-724-2401
  • Fax: 618-724-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: