Healthcare Provider Details

I. General information

NPI: 1699756098
Provider Name (Legal Business Name): LINDA KATHRYN MEDFORD RN, WHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 TIMBER CREEK RD NE
CLEVELAND TN
37323-4060
US

IV. Provider business mailing address

1745 TIMBER CREEK RD NE
CLEVELAND TN
37323-4060
US

V. Phone/Fax

Practice location:
  • Phone: 423-476-5865
  • Fax:
Mailing address:
  • Phone: 423-476-5865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11175
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11175
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: