Basic Information
| Provider Information | |||||||||
| NPI: | 1659425478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIX | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | LOU | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 243 HANOVER ST | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436091836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193821477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5465 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435602155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198858800 | ||||||||
| FaxNumber: | 4198858600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | RN 216529 | OH | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.