Healthcare Provider Details

I. General information

NPI: 1063957769
Provider Name (Legal Business Name): LINDA BARTKO CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33300 CLEVELAND CLINIC BLVD
AVON OH
44011-5733
US

IV. Provider business mailing address

6619 CHERYL ANN DR
INDEPENDENCE OH
44131-3718
US

V. Phone/Fax

Practice location:
  • Phone: 440-695-5000
  • Fax:
Mailing address:
  • Phone: 216-509-6083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.019964
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: