Individual
MRS. LINDA SHODD ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1500 E DOWNING ST, SUITE 208, TAHLEQUAH, OK 74464-3234
(918) 446-2496
(918) 456-7108
Mailing address
300 PENDLETON ST, TAHLEQUAH, OK 74464-2219
(918) 457-7515
(918) 456-7108
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R0059260
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200308880A
—
OK
01
—
R00559260
OK NURSING LICENSE
OK
Enumeration date
04/27/2007
Last updated
08/31/2012
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