Provider Demographics
NPI:1912067059
Name:RODGERS, LINDA ANN (WHNP WOMENS HEALTH N)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:RODGERS
Suffix:
Gender:F
Credentials:WHNP WOMENS HEALTH N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S OBENCHAIN RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524
Mailing Address - Country:US
Mailing Address - Phone:541-826-6115
Mailing Address - Fax:
Practice Address - Street 1:125 S CENTRAL
Practice Address - Street 2:SUITE 201
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501
Practice Address - Country:US
Practice Address - Phone:541-773-8285
Practice Address - Fax:541-773-1634
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR090006629N7WHCNP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR292168Medicaid