Provider Demographics
NPI:1144489014
Name:ROBERSON, LINDA KATHLEEN (CRNA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KATHLEEN
Last Name:ROBERSON
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 1:1238 S MISSOURI AVE
Mailing Address - Street 2:APT. #103 LINDA ROBERSON
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756
Mailing Address - Country:US
Mailing Address - Phone:828-242-2419
Mailing Address - Fax:
Practice Address - Street 1:616 E. STREET
Practice Address - Street 2:WEST COAST ENDOSCOPY CENTER
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756
Practice Address - Country:US
Practice Address - Phone:727-441-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC055196282N00000X, 367500000X
FLARNP654202367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No282N00000XHospitalsGeneral Acute Care Hospital