Provider Demographics
NPI:1043825631
Name:AUGUSTUS, LINDA S
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:AUGUSTUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2987 KING JAMES DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2484
Mailing Address - Country:US
Mailing Address - Phone:937-245-1368
Mailing Address - Fax:
Practice Address - Street 1:2987 KING JAMES DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2484
Practice Address - Country:US
Practice Address - Phone:937-245-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant