Provider Demographics
NPI:1184088171
Name:IMOH, LINDA NGOZI (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:NGOZI
Last Name:IMOH
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 SUMMERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1829
Mailing Address - Country:US
Mailing Address - Phone:469-888-3328
Mailing Address - Fax:469-533-3732
Practice Address - Street 1:9304 FOREST LN STE S-125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:469-577-4009
Practice Address - Fax:469-533-3732
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130766363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care