Healthcare Provider Details

I. General information

NPI: 1194745638
Provider Name (Legal Business Name): LINDA L TROY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S. MAIN STREET
SARDIS MS
38666
US

IV. Provider business mailing address

30 BURTON HILLS BLVD STE 175
NASHVILLE TN
37215-6403
US

V. Phone/Fax

Practice location:
  • Phone: 662-487-1064
  • Fax: 662-487-1381
Mailing address:
  • Phone: 615-988-2014
  • Fax: 615-208-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number681202
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: