Healthcare Provider Details

I. General information

NPI: 1366993974
Provider Name (Legal Business Name): CONSOLIDATED HEALTH SERVICES OF MEMPHIS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 HACKS CROSS RD SUITE 109
MEMPHIS TN
38125-8935
US

IV. Provider business mailing address

3315 HACKS CROSS RD SUITE 109
MEMPHIS TN
38125-8935
US

V. Phone/Fax

Practice location:
  • Phone: 901-509-2232
  • Fax: 901-552-3986
Mailing address:
  • Phone: 901-509-2232
  • Fax: 901-552-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES LITTON
Title or Position: OWNER
Credential: NP
Phone: 901-509-2232