Healthcare Provider Details

I. General information

NPI: 1174771349
Provider Name (Legal Business Name): TIMEKI WILLIAMS DENNIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 12/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2996 KATE BOND RD STE 209
MEMPHIS TN
38133-4030
US

IV. Provider business mailing address

2996 KATE BOND RD STE 209
MEMPHIS TN
38133-4030
US

V. Phone/Fax

Practice location:
  • Phone: 901-300-2970
  • Fax: 901-384-8988
Mailing address:
  • Phone: 901-300-2970
  • Fax: 901-384-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number934
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20396
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: