Healthcare Provider Details

I. General information

NPI: 1508614058
Provider Name (Legal Business Name): HIGHLY FAVORED HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 POPLAR AVE STE 250
MEMPHIS TN
38119-3974
US

IV. Provider business mailing address

6000 POPLAR AVE STE 250
MEMPHIS TN
38119-3974
US

V. Phone/Fax

Practice location:
  • Phone: 901-626-7757
  • Fax:
Mailing address:
  • Phone: 901-626-7757
  • Fax: 901-329-4466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAMEKA LASHAY BUBEN
Title or Position: NURSE PRACTITIONER
Credential: ANP-BC, ANP-C, PMHNP
Phone: 901-626-7757