Provider Demographics
NPI:1457332173
Name:BORKAT, LINDA SUE (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:BORKAT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 2585
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-2585
Mailing Address - Country:US
Mailing Address - Phone:706-660-8505
Mailing Address - Fax:706-660-9390
Practice Address - Street 1:1810 STADIUM DR
Practice Address - Street 2:SUITE 220
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3100
Practice Address - Country:US
Practice Address - Phone:334-664-0210
Practice Address - Fax:334-664-0217
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1077979163W00000X, 363LF0000X
GARN083650163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6126Medicare PIN
P29281Medicare UPIN