MEDICARE: TRINITY ALLIED HEALTH SOLUTIONS

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
1	163W00000X	Registered Nurse	142811	TN
2	363LF0000X	Family Nurse Practitioner	A810629	MS
3	363LF0000X	Family Nurse Practitioner	7247	TN

General Provider Information

NPI Number	:	1700246857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY ALLIED HEALTH SOLUTIONS

Provider Business Mailing Address
First Line	:	PO BOX 750103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38175-0103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2838 HICKORY HILL RD STE 30
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2161
Country	:	US
Telephone Number	:	901-567-7444
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	YAVETTE MONTAGUE
Credential	:	RN
Telephone Number	:	901-567-7444

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	10/01/2021

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Directions to “TRINITY ALLIED HEALTH SOLUTIONS ” Practice Location

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