Healthcare Provider Details

I. General information

NPI: 1174833776
Provider Name (Legal Business Name): LINDA BURNES CRIM CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 BUTTERFLY GARDENS DR
COLUMBUS OH
43215-7508
US

IV. Provider business mailing address

320 W 10TH AVE
COLUMBUS OH
43210-1280
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2000
  • Fax:
Mailing address:
  • Phone: 614-293-4128
  • Fax: 614-293-6037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA.11899-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA11899-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: