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NPI Code Detail

MEDICARE: MS. MARY LINDA DILLARD ARNP

MEDICARE: MS. MARY LINDA DILLARD ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3004742KY
2364SA2200XAdult Health Clinical Nurse Specialist3004742KY

General Provider Information

NPI Number : 1306880034
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY LINDA DILLARD ARNP
Provider Business Mailing Address
First Line : 1102 S VIRGINIA ST
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42240-3579
Country : US
Telephone Number : 270-632-6741
Fax Number : 270-632-6742
Provider Business Practice Location Address
First Line : 1102 S VIRGINIA ST
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42240-3579
Country : US
Telephone Number : 270-632-6741
Fax Number : 270-632-6742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/03/2023

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