Healthcare Provider Details

I. General information

NPI: 1083882591
Provider Name (Legal Business Name): SUE A PILLER ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8974 CLAIR DOUWIE CV
BARTLETT TN
38133-0943
US

IV. Provider business mailing address

8974 CLAIR DOUWIE CV
BARTLETT TN
38133-0943
US

V. Phone/Fax

Practice location:
  • Phone: 901-830-8439
  • Fax: 901-640-0400
Mailing address:
  • Phone: 901-830-8439
  • Fax: 901-640-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN0000013182
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: