Provider Demographics
NPI:1417218603
Name:ROSENFELD, LINDA DEVAULT (CNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DEVAULT
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7660 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9296
Mailing Address - Country:US
Mailing Address - Phone:740-304-4805
Mailing Address - Fax:401-216-3785
Practice Address - Street 1:7660 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9296
Practice Address - Country:US
Practice Address - Phone:740-304-4805
Practice Address - Fax:401-216-3785
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-11478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily