Provider Demographics
NPI:1063468825
Name:SEWELL-HAUENSTEIN, LINDA MAY (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MAY
Last Name:SEWELL-HAUENSTEIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-425-4268
Practice Address - Street 1:311 BOONE STATION ROAD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8592
Practice Address - Country:US
Practice Address - Phone:502-437-8000
Practice Address - Fax:502-437-8001
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2611P363L00000X
KY3002611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50017342OtherPASSPORT
KY78007994Medicaid
KY000000549729OtherANTHEM
KY78007994Medicaid
KYP61868Medicare UPIN