Provider Demographics
NPI:1962174896
Name:DANIEL-DIM, LINDA NWAMAKA (NP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:NWAMAKA
Last Name:DANIEL-DIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:NWAMAKA
Other - Last Name:CHIEKWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5415 NW 95TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-7811
Mailing Address - Country:US
Mailing Address - Phone:816-405-0766
Mailing Address - Fax:
Practice Address - Street 1:3500 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5044
Practice Address - Country:US
Practice Address - Phone:913-680-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021034685363LP0808X
KS81384363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health