MEDICARE: MRS. LINDA L TROY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	681202	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11557998	OTHER	MS	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194745638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA L TROY FNP

Provider Business Mailing Address
First Line	:	30 BURTON HILLS BLVD
Second Line	:	STE 175
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6403
Country	:	US
Telephone Number	:	615-988-2014
Fax Number	:	615-208-1303

Provider Business Practice Location Address
First Line	:	111 S. MAIN STREET
Second Line	:
City	:	SARDIS
State	:	MS
Zip	:	38666
Country	:	US
Telephone Number	:	662-487-1064
Fax Number	:	662-487-1381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	10/18/2018

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