Healthcare Provider Details

I. General information

NPI: 1811585128
Provider Name (Legal Business Name): HEATHER ANN LINKLETTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 01/04/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EAST ST
BENTON ME
04901-3309
US

IV. Provider business mailing address

PO BOX 358
FAIRFIELD ME
04937-0358
US

V. Phone/Fax

Practice location:
  • Phone: 207-453-4708
  • Fax: 207-453-6250
Mailing address:
  • Phone: 207-453-4708
  • Fax: 207-453-6250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN33402
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: