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NPI Code Detail

MEDICARE: JUDY DOLCE LILAVOIS CRNA

MEDICARE: JUDY DOLCE LILAVOIS CRNA
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
1207L00000XAnesthesiology PhysicianAPN0000031843TN
2367500000XCertified Registered Nurse Anesthetist31843TN
3367500000XCertified Registered Nurse AnesthetistRN9347151WI

General Provider Information

NPI Number : 1649912395
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY DOLCE LILAVOIS CRNA
Provider Business Mailing Address
First Line : 8418 ROCKCREEK PKWY
Second Line :
City : CORDOVA
State : TN
Zip : 38016-4593
Country : US
Telephone Number : 954-559-1656
Fax Number :
Provider Business Practice Location Address
First Line : 5545 MURRAY AVE STE 130
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-3861
Country : US
Telephone Number : 901-682-6828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2022
Last Update Date : 01/09/2026

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