Provider Demographics
NPI:1326688193
Name:VAN DYKE, MARIA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNN
Last Name:VAN DYKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:DENTLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3307 BARADA ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-2470
Mailing Address - Country:US
Mailing Address - Phone:402-245-6510
Mailing Address - Fax:402-245-6707
Practice Address - Street 1:3307 BILL SCHOCK BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-2428
Practice Address - Country:US
Practice Address - Phone:402-245-6510
Practice Address - Fax:402-245-6707
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2650363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant