MEDICARE: LINDA CHERYL WOUGHTER ARNP

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	ARNP2849912	FL
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP2849912	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN205309	GA

General Provider Information

NPI Number	:	1790773273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA CHERYL WOUGHTER ARNP

Provider Business Mailing Address
First Line	:	4331 THURMON TANNER RD
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-2829
Country	:	US
Telephone Number	:	678-513-5700
Fax Number	:	678-513-5700

Provider Business Practice Location Address
First Line	:	4331 THURMON TANNER RD
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-2829
Country	:	US
Telephone Number	:	678-513-5700
Fax Number	:	678-513-5700

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	06/07/2010

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