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NPI Code Detail

MEDICARE: LINDA FAY SHAW R.N.

MEDICARE: LINDA FAY SHAW R.N.
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
1163WC1500XCommunity Health Registered NurseRN0000043960TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN0000043960OTHERTNNURSING LICENSE

General Provider Information

NPI Number : 1215121389
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA FAY SHAW R.N.
Provider Business Mailing Address
First Line : 311 23RD AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1503
Country : US
Telephone Number : 615-880-2159
Fax Number : 615-880-2203
Provider Business Practice Location Address
First Line : 1015 E TRINITY LN
Second Line :
City : NASHVILLE
State : TN
Zip : 37216-3029
Country : US
Telephone Number : 615-880-2159
Fax Number : 615-880-2203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2007
Last Update Date : 08/31/2007

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