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General NPI Number Information
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NPI Number | 1811321615
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Entity Type | Individual
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Provider Name | TRACY LINAM
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Gender | Female
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Dates
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Enumeration Date | 08/28/2013
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 1645 FLORENCE RD
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City | SAVANNAH
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State | TN
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Zip | 38372-5210
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Country | US
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Telephone | 731-926-4200
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Fax | 731-926-4205
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Provider Business Mailing Address
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Address Line | 4142 CARMICHAEL RD
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City | MONTGOMERY
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State | AL
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Zip | 36106-2936
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Country | US
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Telephone | 334-213-8803
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Fax | 334-213-8815
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 17898
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License Number State | TN
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