Provider Demographics
NPI:1194021352
Name:FINE, LINDA DARLENE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DARLENE
Last Name:FINE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-9063
Mailing Address - Country:US
Mailing Address - Phone:615-975-3819
Mailing Address - Fax:
Practice Address - Street 1:3005 AMBROSE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-4709
Practice Address - Country:US
Practice Address - Phone:184-467-3696
Practice Address - Fax:184-467-3696
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily