Linda Roth

Individual provider Active NPI Registered Nurse · Cheyenne Wells, CO

NPI 1962564005 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1962564005
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
47309 (CO)
Practice address
615 W 5 N
Cheyenne Wells, CO 80810
Phone
(719) 767-5616
Fax
(719) 767-8747
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
County of Cheyenne Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 47309 CO Yes

Addresses

Primary practice location

615 W 5 N
Cheyenne Wells, CO 80810

Mailing address

PO Box 38
Cheyenne Wells, CO 80810-0038
Phone (719) 767-5616

Other identifiers

IdentifierTypeStateIssuer
27233782MedicaidCO

Other providers in Cheyenne Wells, CO

All providers in Cheyenne Wells, CO · Registered Nurse in Colorado

Sources for this page

Verify at the official NPI Registry.