Healthcare Provider Details

I. General information

NPI: 1912048299
Provider Name (Legal Business Name): LINDA H. HENSLEY RN, MSN, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MCGHEE ST
MARYVILLE TN
37801-6811
US

IV. Provider business mailing address

301 MCGHEE ST
MARYVILLE TN
37801-6811
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-4582
  • Fax: 865-983-4574
Mailing address:
  • Phone: 865-983-4582
  • Fax: 865-983-4574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000005208
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: