Healthcare Provider Details

I. General information

NPI: 1275978322
Provider Name (Legal Business Name): LINDA MARIE NORTH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BLACKFORD ST
CHATTANOOGA TN
37403-1405
US

IV. Provider business mailing address

910 BLACKFORD ST
CHATTANOOGA TN
37403-1405
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-6575
  • Fax: 423-778-4231
Mailing address:
  • Phone: 423-778-6575
  • Fax: 423-778-4231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000017572
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: