Provider Demographics
NPI:1770539587
Name:MCKNIGHT, LINDA D (WHCNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9202 ELAM RD
Practice Address - Street 2:SOUTHEAST DALLAS WOMEN'S HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4151
Practice Address - Country:US
Practice Address - Phone:214-266-1500
Practice Address - Fax:214-266-1505
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589485363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042495406Medicaid
TX042495411Medicaid
TX8Y1739OtherBLUE CROSS BLUE SHIELD
TX042495412Medicaid
TX042495404Medicaid
TX042495408Medicaid
TX042495409Medicaid
TX042495402Medicaid
TX042495403Medicaid
TX042495405Medicaid
TX042495407Medicaid
TX042495403Medicaid