MEDICARE: LINDA MOSBY 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	363L00000X	Nurse Practitioner	5949	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578559605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA MOSBY FNP

Provider Business Mailing Address
First Line	:	877 JEFFERSON AVE
Second Line	:	5TH FLOOR ADAMS PAVILION
City	:	MEMPHIS
State	:	TN
Zip	:	38103-2807
Country	:	US
Telephone Number	:	901-272-0387
Fax Number	:	901-272-0292

Provider Business Practice Location Address
First Line	:	1955 S 3RD ST
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38109-7713
Country	:	US
Telephone Number	:	901-515-5800
Fax Number	:	901-946-3333

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	12/31/2009

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Directions to “ LINDA MOSBY FNP” Practice Location

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