Linda Groom, RN

Individual provider Active NPI Community Health Registered Nurse · Benson, AZ

NPI 1154585818 · NPPES record last updated Jul 11, 2008

Key facts

NPI
1154585818
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN066905 (AZ)
Practice address
470 S Ocotillo Ave
Benson, AZ 85602-6403
Phone
(520) 287-4713
Fax
(520) 287-9794
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN066905AZMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN066905 AZ Yes

Addresses

Primary practice location

470 S Ocotillo Ave
Benson, AZ 85602-6403

Mailing address

470 S Ocotillo Ave
Benson, AZ 85602-6403
Phone (520) 287-4713

Other identifiers

IdentifierTypeStateIssuer
RN066905OtherAZRN

Other providers in Benson, AZ

All providers in Benson, AZ · Community Health Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.