MEDICARE: MS. LINDA JILL STAUFENBERG R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SA2200X	Adult Health Clinical Nurse Specialist	150104	OH

General Provider Information

NPI Number	:	1164503843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA JILL STAUFENBERG R.N.

Provider Business Mailing Address
First Line	:	6407 NEWGRANGE DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-8211
Country	:	US
Telephone Number	:	614-873-4244
Fax Number	:

Provider Business Practice Location Address
First Line	:	5025 ARLINGTON CENTRE BLVD
Second Line	:	SUITE 500
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2959
Country	:	US
Telephone Number	:	614-538-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2010

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