Provider Demographics
NPI:1821420191
Name:LININGER, PAMELA S (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:S
Last Name:LININGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S MCCLURE ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:OK
Mailing Address - Zip Code:74728-4736
Mailing Address - Country:US
Mailing Address - Phone:580-236-4268
Mailing Address - Fax:580-584-2537
Practice Address - Street 1:402 S MCCLURE ST
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:OK
Practice Address - Zip Code:74728-4736
Practice Address - Country:US
Practice Address - Phone:580-236-4268
Practice Address - Fax:580-584-2537
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0033335164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse