Provider Demographics
NPI:1770849127
Name:CABAGE, LINDA (MSN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CABAGE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:RUTH
Other - Last Name:FULLINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:641 MORGANTON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-4763
Mailing Address - Country:US
Mailing Address - Phone:865-724-1590
Mailing Address - Fax:865-924-1591
Practice Address - Street 1:641 MORGANTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4763
Practice Address - Country:US
Practice Address - Phone:865-724-1590
Practice Address - Fax:865-724-1591
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN159881363LP0808X
TNAPN16616363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health