Basic Information
Provider Information
NPI: 1366740375
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMON
FirstName: LINDA
MiddleName: FAY
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7865 EDUCATORS LANE
Address2: SUITE 300 LUNCEFORD FAMILY HEALTH CENTER
City: BARTLETT
State: TN
PostalCode: 38133
CountryCode: US
TelephoneNumber: 9013849920
FaxNumber: 9019377879
Practice Location
Address1: 7865 EDUCATORS LANE
Address2: SUITE 300 LUNCEFORD FAMILY HEALTH CENTER
City: BARTLETT
State: TN
PostalCode: 38133
CountryCode: US
TelephoneNumber: 9013849920
FaxNumber: 9019377879
Other Information
ProviderEnumerationDate: 03/01/2011
LastUpdateDate: 03/01/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X15523TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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