Provider Demographics
NPI:1306030325
Name:DIMMICK, LINDA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:DIMMICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 TAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-3758
Mailing Address - Country:US
Mailing Address - Phone:937-832-4810
Mailing Address - Fax:
Practice Address - Street 1:6520 TAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-3758
Practice Address - Country:US
Practice Address - Phone:937-832-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.087908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse