Healthcare Provider Details

I. General information

NPI: 1730543562
Provider Name (Legal Business Name): MEKESHIA SANDERS RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4168 N AMANDA CIR APT 7
MEMPHIS TN
38128-7155
US

IV. Provider business mailing address

4168 N AMANDA CIR APT 7
MEMPHIS TN
38128-7155
US

V. Phone/Fax

Practice location:
  • Phone: 901-314-7230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number5778
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2278E1000X
TaxonomyEducational Certified Respiratory Therapist
License Number5778
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License Number5778
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2278P3800X
TaxonomyPalliative/Hospice Certified Respiratory Therapist
License Number5778
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code2278S1500X
TaxonomySNF/Subacute Care Certified Respiratory Therapist
License Number5778
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number5778
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code2279E0002X
TaxonomyEmergency Care Registered Respiratory Therapist
License Number5778
License Number StateTN
# 8
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number5778
License Number StateTN
# 9
Primary TaxonomyN
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number5778
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: