Provider Demographics
NPI:1326200130
Name:ROEMER, LINDA (PHD NP-C)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:ROEMER
Suffix:
Gender:F
Credentials:PHD NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3635
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2561
Mailing Address - Country:US
Mailing Address - Phone:850-896-1387
Mailing Address - Fax:
Practice Address - Street 1:2030 W STATE ROUTE 89A STE B2A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5593
Practice Address - Country:US
Practice Address - Phone:850-896-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8628363LP0808X
AZAP3515363LA2200X
FL1376612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS69570Medicare UPIN