Provider Demographics
NPI:1174699979
Name:HANSEN-RODIER, LINDA (ARNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HANSEN-RODIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ANDOVER STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NO. ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-691-5690
Mailing Address - Fax:978-691-5693
Practice Address - Street 1:62 BROWN STREET
Practice Address - Street 2:SUITE 304C
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-374-6770
Practice Address - Fax:978-374-1746
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH029940-23-04363L00000X
MA158677363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110025235AMedicaid
MANP428003Medicare PIN