Provider Demographics
NPI:1851398879
Name:AVILA, LINDA KAY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:AVILA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KAY
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2909 SE WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-2189
Mailing Address - Country:US
Mailing Address - Phone:785-267-0744
Mailing Address - Fax:785-266-3490
Practice Address - Street 1:2909 SE WALNUT DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-2189
Practice Address - Country:US
Practice Address - Phone:785-267-0744
Practice Address - Fax:785-266-3490
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00909363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP98903Medicare UPIN
TXP98903Medicare UPIN