Provider Demographics
NPI:1417911769
Name:COLE, LINDA SUE (MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:COLE
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WATERFORD PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2687
Mailing Address - Country:US
Mailing Address - Phone:865-717-1121
Mailing Address - Fax:865-717-1103
Practice Address - Street 1:900 WATERFORD PL
Practice Address - Street 2:SUITE 100
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2687
Practice Address - Country:US
Practice Address - Phone:865-717-1121
Practice Address - Fax:865-717-1103
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 05165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01275Medicare UPIN
TN39058611Medicare PIN
TN3734289Medicare PIN