Provider Demographics
NPI:1992117519
Name:DIMICK, JELINDA VANLORA (APRN)
Entity type:Individual
Prefix:MISS
First Name:JELINDA
Middle Name:VANLORA
Last Name:DIMICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JELINDA
Other - Middle Name:VANLORA
Other - Last Name:PIMENTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 CHIEFS WAY STE 1 PMB 207
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-1100
Mailing Address - Country:US
Mailing Address - Phone:850-490-3849
Mailing Address - Fax:
Practice Address - Street 1:4968 WABASH PINE CT
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32571-2768
Practice Address - Country:US
Practice Address - Phone:850-490-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318229-31164W00000X
FL11040535363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse