Individual
LINDA J MCILWEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
600 S MONROE ST, ENID, OK 73701-7211
(580) 233-2300
(580) 237-6174
Mailing address
626 DEER RUN, ENID, OK 73703-3426
(580) 242-3003
(580) 237-6174
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
R0024786
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
R0024786
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100788620A
—
OK
Enumeration date
07/01/2006
Last updated
10/24/2016
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