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General NPI Number Information
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NPI Number | 1548281785
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Entity Type | Individual
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Provider Name | LINDA R QUILLEN N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 818 SUNSET DR SUITE 103
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City | JOHNSON CITY
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State | TN
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Zip | 37604-8310
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Country | US
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Telephone | 423-794-3142
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Fax | 423-794-3184
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Provider Business Mailing Address
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Address Line | 818 SUNSET DR SUITE 103
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City | JOHNSON CITY
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State | TN
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Zip | 37604-8310
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Country | US
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Telephone | 423-794-3142
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Fax | 423-794-3184
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APN6094
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 6094
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License Number State | TN
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