Healthcare Provider Details
I. General information
NPI: 1275998577
Provider Name (Legal Business Name): NATASHA Y GOINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/31/2015
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7705 POPLAR AVE STE 220
GERMANTOWN TN
38138-3930
US
IV. Provider business mailing address
1211 UNION AVE STE 330
MEMPHIS TN
38104-6655
US
V. Phone/Fax
- Phone: 901-516-6792
- Fax: 901-266-6459
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 20913 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: