Healthcare Provider Details

I. General information

NPI: 1033153077
Provider Name (Legal Business Name): LINDA DENISE STEMP FNP, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6667 VERNON WOODS DR STE A19
SANDY SPRINGS GA
30328-3215
US

IV. Provider business mailing address

512 JOHANNAH PL SW
LILBURN GA
30047-3080
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-3500
  • Fax: 404-252-3600
Mailing address:
  • Phone: 404-441-7397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN170552
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN170552
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN170552
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: