Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5015103 | NC |
NPI | 1003587510 |
---|---|
Provider Name | Tabitha Leann Linville |
First Address | Chapel Hill, NC 27516-4569 |
Second Address | Chapel Hill, NC 27514-4423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2021 |
Last Update Date | 23/09/2021 |