Provider Demographics
NPI:1366584807
Name:MORELLI, LYNDA MARIE (APRN)
Entity type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:MARIE
Last Name:MORELLI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:LYNDA
Other - Middle Name:MARIE
Other - Last Name:MANNETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7074 MAYFAIR ST
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8528
Mailing Address - Country:US
Mailing Address - Phone:865-475-2120
Mailing Address - Fax:855-544-2120
Practice Address - Street 1:1004 N HIGHWAY 92
Practice Address - Street 2:SUITE C
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-3687
Practice Address - Country:US
Practice Address - Phone:865-475-2120
Practice Address - Fax:855-544-2120
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12749OtherTN APN