Healthcare Provider Details

I. General information

NPI: 1275928004
Provider Name (Legal Business Name): TATIANA VORONCHIKHINA MSN, BA, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9608 DALY DR
LAKELAND TN
38002-4286
US

IV. Provider business mailing address

9145 FOREST WIND DR
COLLIERVILLE TN
38017-9390
US

V. Phone/Fax

Practice location:
  • Phone: 901-878-9608
  • Fax:
Mailing address:
  • Phone: 901-496-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-3717
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0000180639
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19839
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: