Provider Demographics
NPI:1124002928
Name:SIEGL, LINDA S (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:SIEGL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 HIGHWAY 114 S
Mailing Address - Street 2:P. O. BOX 99
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-5023
Mailing Address - Country:US
Mailing Address - Phone:731-549-3191
Mailing Address - Fax:731-549-3005
Practice Address - Street 1:644 HIGHWAY 114 S
Practice Address - Street 2:
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-5023
Practice Address - Country:US
Practice Address - Phone:731-549-3191
Practice Address - Fax:731-549-3005
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4043739OtherBLUE CROSS PROVIDER NUMBE
TN3343848Medicaid
TN3343848Medicaid
TN4043739OtherBLUE CROSS PROVIDER NUMBE
TNS40665Medicare UPIN