Individual
LINDA B WILK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
575 NORTH RIVER ST, WILKES-BARRE, PA 18764
(570) 829-8111
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
072065
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00181872
RR MEDICARE
PA
01
—
P00952235
RR MEDICARE
PA
01
—
P01004286
RAILROAD MEDICARE
PA
Enumeration date
12/01/2005
Last updated
03/27/2015
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