Provider Demographics
NPI:1972608669
Name:WILLIAMS, LINDA ROSE (APN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ROSE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-0399
Mailing Address - Country:US
Mailing Address - Phone:931-962-4040
Mailing Address - Fax:931-962-2277
Practice Address - Street 1:1894 COWAN HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2643
Practice Address - Country:US
Practice Address - Phone:931-962-4040
Practice Address - Fax:931-962-2277
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN APN 11831363LA2100X
TN11831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3643989Medicaid