Provider Demographics
NPI:1164098505
Name:VOTH, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:VOTH
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 1:716 TWEED
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-1596
Mailing Address - Country:US
Mailing Address - Phone:620-221-4141
Mailing Address - Fax:620-221-4146
Practice Address - Street 1:716 TWEED
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-1596
Practice Address - Country:US
Practice Address - Phone:620-221-4141
Practice Address - Fax:620-221-4146
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1106150001Medicaid