Healthcare Provider Details

I. General information

NPI: 1336284363
Provider Name (Legal Business Name): LINDA W ROGERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HOSPITAL DR
ATHENS OH
45701-2301
US

IV. Provider business mailing address

90 HOSPITAL DR
ATHENS OH
45701-2301
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-3682
  • Fax: 740-594-5642
Mailing address:
  • Phone: 740-593-3682
  • Fax: 740-594-5642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN.149558
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: