Provider Demographics
NPI:1487792149
Name:JESSEE, LINDA CHARLENE (RN)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CHARLENE
Last Name:JESSEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3737
Mailing Address - Country:US
Mailing Address - Phone:423-239-4329
Mailing Address - Fax:
Practice Address - Street 1:1233 SW AVE EXT
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-979-4630
Practice Address - Fax:423-979-3267
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000037675163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health