Healthcare Provider Details

I. General information

NPI: 1639160120
Provider Name (Legal Business Name): LINDA H GRIFFITH APN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 HILLCREST DR
CLARKSVILLE TN
37043-5093
US

IV. Provider business mailing address

PO BOX 3799
CLARKSVILLE TN
37043-3799
US

V. Phone/Fax

Practice location:
  • Phone: 931-245-8500
  • Fax: 931-245-7068
Mailing address:
  • Phone: 931-245-8500
  • Fax: 931-245-7068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5655APN
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: