Provider Demographics
NPI:1861502650
Name:HINRICHS, LINDA SUE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:HINRICHS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5623 S 440
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74352-1279
Mailing Address - Country:US
Mailing Address - Phone:918-479-3694
Mailing Address - Fax:
Practice Address - Street 1:5623 S 440
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:OK
Practice Address - Zip Code:74352-1279
Practice Address - Country:US
Practice Address - Phone:918-479-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC01185367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered