Provider Demographics
NPI:1831792373
Name:BOYER, LINDA K (INDEPENDENT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:BOYER
Suffix:
Gender:F
Credentials:INDEPENDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4994 WOOSTER RD W
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-6259
Mailing Address - Country:US
Mailing Address - Phone:330-608-1232
Mailing Address - Fax:
Practice Address - Street 1:4994 WOOSTER RD W
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-6259
Practice Address - Country:US
Practice Address - Phone:330-608-1232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2245798Medicaid