Provider Demographics
NPI:1184758757
Name:NOCILLA, LINDA M (CLS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:NOCILLA
Suffix:
Gender:F
Credentials:CLS
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLS
Mailing Address - Street 1:20111 W PASADENA AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-6103
Mailing Address - Country:US
Mailing Address - Phone:928-669-3224
Mailing Address - Fax:
Practice Address - Street 1:12033 AGENCY RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-7718
Practice Address - Country:US
Practice Address - Phone:928-669-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management