Healthcare Provider Details

I. General information

NPI: 1417291410
Provider Name (Legal Business Name): LOUISE ANNE LINKE GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 E HENRIETTA RD
ROCHESTER NY
14620-4629
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX SHG
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-760-5469
  • Fax: 585-424-4184
Mailing address:
  • Phone: 585-760-5469
  • Fax: 585-424-4184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF340707-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: