Provider Demographics
NPI:1104974971
Name:SILLARS, LINDA P (PMHNP, BC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:P
Last Name:SILLARS
Suffix:
Gender:F
Credentials:PMHNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 STOCKMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1638
Mailing Address - Country:US
Mailing Address - Phone:315-685-1603
Mailing Address - Fax:
Practice Address - Street 1:35 STOCKMAN AVE
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1638
Practice Address - Country:US
Practice Address - Phone:315-253-0341
Practice Address - Fax:315-253-1687
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP161060363LP0808X
NYF401025-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health