MEDICARE: LINDA STOVER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	102477	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609870393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA STOVER FNP

Provider Business Mailing Address
First Line	:	330 FRANKLIN RD. #135A-393
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027
Country	:	US
Telephone Number	:	615-309-3300
Fax Number	:	615-309-3338

Provider Business Practice Location Address
First Line	:	457 VISTA DR
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1360
Country	:	US
Telephone Number	:	931-738-4595
Fax Number	:	931-738-4596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/25/2009

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