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NPI Code Detail

MEDICARE: SHIRLEY ANN SPILLER-JOHNSON

MEDICARE: SHIRLEY ANN SPILLER-JOHNSON
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
1311ZA0620XAdult Care Home Facility00000565TN

General Provider Information

NPI Number : 1437468295
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHIRLEY ANN SPILLER-JOHNSON
Provider Business Mailing Address
First Line : 2051 MONTREAT DR
Second Line :
City : MEMPHIS
State : TN
Zip : 38134-6613
Country : US
Telephone Number : 901-388-6903
Fax Number : 901-388-7366
Provider Business Practice Location Address
First Line : 2051 MONTREAT DR
Second Line :
City : MEMPHIS
State : TN
Zip : 38134-6613
Country : US
Telephone Number : 901-388-6903
Fax Number : 901-388-7366
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. SHIRLEY ANN SPILLER-JOHNSON
Credential : LPN
Telephone Number : 901-388-6903
Provider Enumeration Date : 09/28/2010
Last Update Date : 11/18/2010

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Directions to “SHIRLEY ANN SPILLER-JOHNSON ” Practice Location

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