Healthcare Provider Details

I. General information

NPI: 1063468825
Provider Name (Legal Business Name): LINDA MAY SEWELL-HAUENSTEIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 BOONE STATION ROAD
SHELBYVILLE KY
40065-8592
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 502-437-8000
  • Fax: 502-437-8001
Mailing address:
  • Phone: 615-425-4200
  • Fax: 615-425-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2611P
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3002611
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: