Healthcare Provider Details

I. General information

NPI: 1679501621
Provider Name (Legal Business Name): LINDA MARIE WOODFIN-HIGHTOWER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W RUTHERFORD ST
LANDRUM SC
29356-1526
US

IV. Provider business mailing address

PO BOX 657
LANDRUM SC
29356-0657
US

V. Phone/Fax

Practice location:
  • Phone: 864-457-2363
  • Fax: 864-457-2731
Mailing address:
  • Phone: 864-457-2363
  • Fax: 864-457-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1614
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: