Healthcare Provider Details

I. General information

NPI: 1053749648
Provider Name (Legal Business Name): EMILY ANN PROMISEL PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANN RASNICK PTA

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 STAGE HILLS BLVD
BARTLETT TN
38133-4037
US

IV. Provider business mailing address

8010 STAGE HILLS BLVD
BARTLETT TN
38133-4037
US

V. Phone/Fax

Practice location:
  • Phone: 901-937-3200
  • Fax: 901-725-8346
Mailing address:
  • Phone: 901-937-3200
  • Fax: 901-725-8346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5575
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: