Provider Demographics
NPI:1033153077
Name:STEMP, LINDA DENISE (FNP, PHD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DENISE
Last Name:STEMP
Suffix:
Gender:F
Credentials:FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 JOHANNAH PL SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3080
Mailing Address - Country:US
Mailing Address - Phone:404-441-7397
Mailing Address - Fax:
Practice Address - Street 1:6667 VERNON WOODS DR STE A19
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3215
Practice Address - Country:US
Practice Address - Phone:404-252-3500
Practice Address - Fax:404-252-3600
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN170552363L00000X, 163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP20787Medicare UPIN