Healthcare Provider Details

I. General information

NPI: 1619942919
Provider Name (Legal Business Name): LINDA HOPE DILLING CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA HOPE DILLING

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S 5TH ST SUITE 103
ENID OK
73701-5825
US

IV. Provider business mailing address

PO BOX 844737 ATT: IPM CREDENTIALING
DALLAS TX
75284-4737
US

V. Phone/Fax

Practice location:
  • Phone: 580-249-3027
  • Fax: 580-234-5970
Mailing address:
  • Phone: 855-298-6628
  • Fax: 903-416-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR32448
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: