Provider Demographics
NPI:1972188076
Name:DICOLA, LINDA WILEY (AARN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:WILEY
Last Name:DICOLA
Suffix:
Gender:F
Credentials:AARN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9653 PAMUNKEY DR
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3645
Mailing Address - Country:US
Mailing Address - Phone:703-408-6261
Mailing Address - Fax:
Practice Address - Street 1:8323 EDEN DR
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-4130
Practice Address - Country:US
Practice Address - Phone:540-775-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001131739163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology