Provider Demographics
NPI:1750360632
Name:LINK, LILLIAN M (CNP)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:M
Last Name:LINK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8146 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2324
Mailing Address - Country:US
Mailing Address - Phone:513-588-3623
Mailing Address - Fax:513-728-4064
Practice Address - Street 1:8146 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2324
Practice Address - Country:US
Practice Address - Phone:513-588-3623
Practice Address - Fax:513-728-4064
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP10414363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP 10414OtherLICENSE #
S29029Medicare UPIN
OHNP 10414OtherLICENSE #