Healthcare Provider Details

I. General information

NPI: 1619314564
Provider Name (Legal Business Name): ALLISON MARIE STOCK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2013
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 POPLAR AVE STE 500
MEMPHIS TN
38119-4808
US

IV. Provider business mailing address

6401 POPLAR AVE STE 500
MEMPHIS TN
38119-4808
US

V. Phone/Fax

Practice location:
  • Phone: 901-227-2360
  • Fax: 901-227-2367
Mailing address:
  • Phone: 901-746-9438
  • Fax: 901-746-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17594
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: