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General NPI Number Information
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NPI Number | 1336132398
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Entity Type | Individual
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Provider Name | LINDA RUTH HERTZ R.N.,C.N.S.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 REED ST SUITE 115
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City | MANKATO
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State | MN
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Zip | 56001-6410
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Country | US
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Telephone | 507-625-4060
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Fax | 507-625-3915
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Provider Business Mailing Address
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Address Line | 115 ECHO ST #406
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City | MANKATO
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State | MN
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Zip | 56001-6156
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Country | US
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Telephone | 507-625-4060
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Fax | 507-625-3915
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 0349305
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License Number State | MN
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