Provider Demographics
NPI:1386023711
Name:DUMAS, LINDA
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:DUMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 COLLIER CORPORATE PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6707
Mailing Address - Country:US
Mailing Address - Phone:636-493-1408
Mailing Address - Fax:
Practice Address - Street 1:2101 COLLIER CORPORATE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6707
Practice Address - Country:US
Practice Address - Phone:636-493-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13501376K00000X, 163WH0200X, 164W00000X, 372500000X, 372600000X, 374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No376K00000XNursing Service Related ProvidersNurse's Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker