Provider Demographics
NPI:1518943034
Name:ROGERS-SALTER, LINNA M (CRNA)
Entity Type:Individual
Prefix:
First Name:LINNA
Middle Name:M
Last Name:ROGERS-SALTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2979 GREYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8453
Mailing Address - Country:US
Mailing Address - Phone:850-995-1193
Mailing Address - Fax:850-995-1193
Practice Address - Street 1:6002 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-5062
Practice Address - Country:US
Practice Address - Phone:850-626-5013
Practice Address - Fax:850-626-5256
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1660582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301263800Medicaid
FLG1430OtherBLUE CROSS BLUE SHIELD
AL009913451Medicaid
FL301263800Medicaid
AL009913451Medicaid