Healthcare Provider Details

I. General information

NPI: 1447062476
Provider Name (Legal Business Name): TIA HELTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7751 DRISCOLL ST
MEMPHIS TN
38125-3464
US

IV. Provider business mailing address

7751 DRISCOLL ST
MEMPHIS TN
38125-3464
US

V. Phone/Fax

Practice location:
  • Phone: 901-494-0509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0105572
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1225456
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number38414
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number334156
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: