1063584704 NPI number — MRS. LINDA THOMPSON ROGERS APRN

Table of content: MRS. LINDA THOMPSON ROGERS APRN (NPI 1063584704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063584704 NPI number — MRS. LINDA THOMPSON ROGERS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
LINDA
Provider Middle Name:
THOMPSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMPSON
Provider Other First Name:
LINDA
Provider Other Middle Name:
MAE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063584704
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 LAMP POST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INMAN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-472-9435
Provider Business Mailing Address Fax Number:
864-472-5071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SPARTANBURG COUNTY HEALTH OFFICE-REGION 2
Provider Second Line Business Practice Location Address:
151 EAST WOOD STREET
Provider Business Practice Location Address City Name:
SPARTANBERG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29305-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-596-2227
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  675 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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