Healthcare Provider Details

I. General information

NPI: 1982617221
Provider Name (Legal Business Name): VICKI LITTLE CHANDLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 PARK AVE SUITE 100
MEMPHIS TN
38119-3500
US

IV. Provider business mailing address

5220 PARK AVE STE 100
MEMPHIS TN
38119-3541
US

V. Phone/Fax

Practice location:
  • Phone: 901-685-8245
  • Fax: 901-685-8248
Mailing address:
  • Phone: 901-685-8245
  • Fax: 901-685-8248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN64657
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN5907
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: