Provider Demographics
NPI:1982664314
Name:MEINTSCOOPER, LINDA C (APN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:MEINTSCOOPER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 COLLEGE AND UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61790-2540
Mailing Address - Country:US
Mailing Address - Phone:309-438-2956
Mailing Address - Fax:309-438-3689
Practice Address - Street 1:2540 COLLEGE AND UNIVERSITY
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61790-2540
Practice Address - Country:US
Practice Address - Phone:309-438-2956
Practice Address - Fax:309-438-3689
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MC0798415OtherDEA