Provider Demographics
NPI:1871818302
Name:HERRICK, LINDA MAE (R)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MAE
Last Name:HERRICK
Suffix:
Gender:F
Credentials:R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3553 OREGON RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-8436
Mailing Address - Country:US
Mailing Address - Phone:785-242-6423
Mailing Address - Fax:
Practice Address - Street 1:3553 OREGON RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-8436
Practice Address - Country:US
Practice Address - Phone:785-242-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-48088-072163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn