Provider Demographics
NPI:1790331650
Name:GILL, LINDA ROSE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ROSE
Last Name:GILL
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 1:880 ROSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1705
Mailing Address - Country:US
Mailing Address - Phone:614-207-9778
Mailing Address - Fax:614-866-3565
Practice Address - Street 1:880 ROSEHILL RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-1705
Practice Address - Country:US
Practice Address - Phone:614-207-9778
Practice Address - Fax:614-866-3565
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider