Individual
LINDA S LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3893 E MARKET ST, WARREN, OH 44484-4706
(330) 856-1272
(330) 856-2960
Mailing address
3622 BELMONT AVE, SUITE 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-135649
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.00492-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0847963
—
OH
01
—
11894927
CAQH
OH
Enumeration date
05/09/2006
Last updated
03/17/2011
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