Provider Demographics
NPI:1912048299
Name:HENSLEY, LINDA H (RN, MSN, APN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:H
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:RN, MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MCGHEE ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-6811
Mailing Address - Country:US
Mailing Address - Phone:865-983-4582
Mailing Address - Fax:865-983-4574
Practice Address - Street 1:301 MCGHEE ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-6811
Practice Address - Country:US
Practice Address - Phone:865-983-4582
Practice Address - Fax:865-983-4574
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN100025435OtherPHP TENNCARE
TN3348547OtherBUREAU OF TENNCARE