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NPI Code Detail

MEDICARE: MIKAELE RECTOR CPNP-PC

MEDICARE: MIKAELE RECTOR CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner34864TN

General Provider Information

NPI Number : 1225819352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAELE RECTOR CPNP-PC
Provider Business Mailing Address
First Line : 6063 MT MORIAH RD EXT
Second Line :
City : MEMPHIS
State : TN
Zip : 38115-2757
Country : US
Telephone Number : 901-531-8800
Fax Number :
Provider Business Practice Location Address
First Line : 6625 LENOX PARK DR STE 101
Second Line :
City : MEMPHIS
State : TN
Zip : 38115-4397
Country : US
Telephone Number : 901-683-0024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2023
Last Update Date : 04/26/2024

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Directions to “ MIKAELE RECTOR CPNP-PC” Practice Location

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