Healthcare Provider Details

I. General information

NPI: 1255294088
Provider Name (Legal Business Name): ABBY BARTHOLOMEW NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 JEFFERSON AVE
MEMPHIS TN
38103-2807
US

IV. Provider business mailing address

4010 ABBAWOOD
OXFORD MS
38655-1059
US

V. Phone/Fax

Practice location:
  • Phone: 901-545-7366
  • Fax:
Mailing address:
  • Phone: 901-258-8152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberR897725
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: