Provider Demographics
NPI:1457094476
Name:KRUTKO, LINDA ANN
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:KRUTKO
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 1:28862 US HIGHWAY 52
Mailing Address - Street 2:
Mailing Address - City:STOUT
Mailing Address - State:OH
Mailing Address - Zip Code:45684-9714
Mailing Address - Country:US
Mailing Address - Phone:614-439-2518
Mailing Address - Fax:
Practice Address - Street 1:28862 US HIGHWAY 52
Practice Address - Street 2:
Practice Address - City:STOUT
Practice Address - State:OH
Practice Address - Zip Code:45684-9714
Practice Address - Country:US
Practice Address - Phone:614-439-2518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health