Healthcare Provider Details

I. General information

NPI: 1174603203
Provider Name (Legal Business Name): GERIATRIC PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6263 POPLAR AVE SUITE 1052
MEMPHIS TN
38119-4701
US

IV. Provider business mailing address

6263 POPLAR AVE SUITE 1052
MEMPHIS TN
38119-4701
US

V. Phone/Fax

Practice location:
  • Phone: 901-761-6157
  • Fax:
Mailing address:
  • Phone: 901-761-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DEBRA COLLINS
Title or Position: OWNER
Credential: FNP
Phone: 901-761-6157