Healthcare Provider Details

I. General information

NPI: 1326106915
Provider Name (Legal Business Name): ALLISON WYNNE MCQUIRTER CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 GRAND AVE
YAZOO CITY MS
39194-3233
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 662-751-8289
  • Fax: 662-751-8279
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR850880
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: