Basic Information
| Provider Information | |||||||||
| NPI: | 1912992926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 PATTERSON ST | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153404611 | ||||||||
| FaxNumber: | 6153404658 | ||||||||
| Practice Location | |||||||||
| Address1: | 2410 PATTERSON ST | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153404611 | ||||||||
| FaxNumber: | 6153404658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN0000035556 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 3348059 | 05 | TN | MEDICAID |