Healthcare Provider Details

I. General information

NPI: 1902976756
Provider Name (Legal Business Name): LINDA SUE TETTAMBEL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WOODFIN ST
ASHEVILLE NC
28801-3020
US

IV. Provider business mailing address

22 DAYFLOWER DR
ASHEVILLE NC
28803-9618
US

V. Phone/Fax

Practice location:
  • Phone: 828-250-5000
  • Fax:
Mailing address:
  • Phone: 828-713-7583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number143725
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: