Healthcare Provider Details

I. General information

NPI: 1073844627
Provider Name (Legal Business Name): JOHANNA M LINKER-LOPES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 E RIDGE RD
ROCHESTER NY
14621-1229
US

IV. Provider business mailing address

3071 KENYON RD
WILLIAMSON NY
14589-9526
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-2500
  • Fax: 585-922-2646
Mailing address:
  • Phone: 315-589-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number487981-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN514199L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: