Provider Demographics
NPI:1619942919
Name:DILLING, LINDA HOPE (CNS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:HOPE
Last Name:DILLING
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:HOPE
Other - Last Name:DILLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 844737
Mailing Address - Street 2:ATT: IPM CREDENTIALING
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4737
Mailing Address - Country:US
Mailing Address - Phone:855-298-6628
Mailing Address - Fax:903-416-1701
Practice Address - Street 1:330 S 5TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5825
Practice Address - Country:US
Practice Address - Phone:580-249-3027
Practice Address - Fax:580-234-5970
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR32448363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100100520BMedicaid
OK100100520AMedicaid
OK100100520AMedicaid
OK100100520BMedicaid
OKOK700768Medicare PIN
OK424656YPW9Medicare PIN