Basic Information
| Provider Information | |||||||||
| NPI: | 1750360632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINK | ||||||||
| FirstName: | LILLIAN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8146 HAMILTON AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452312324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135883623 | ||||||||
| FaxNumber: | 5137284064 | ||||||||
| Practice Location | |||||||||
| Address1: | 8146 HAMILTON AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452312324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135883623 | ||||||||
| FaxNumber: | 5137284064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 09/23/2015 | ||||||||
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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 | 363LF0000X | NP10414 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | NP 10414 | 01 | OH | LICENSE # | OTHER |