Provider Demographics
NPI:1194745638
Name:TROY, LINDA L (FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:TROY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BURTON HILLS BLVD
Mailing Address - Street 2:STE 175
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-208-1303
Practice Address - Street 1:111 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:MS
Practice Address - Zip Code:38666
Practice Address - Country:US
Practice Address - Phone:662-487-1064
Practice Address - Fax:662-487-1381
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS681202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS11557998OtherCAQH
MS09232509Medicaid
MS11557998OtherCAQH