Healthcare Provider Details

I. General information

NPI: 1679279210
Provider Name (Legal Business Name): NADJA BARROS BARRANTES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 UNION AVE
MEMPHIS TN
38174-0275
US

IV. Provider business mailing address

965 RIDGE LAKE BLVD STE 315
MEMPHIS TN
38120-9401
US

V. Phone/Fax

Practice location:
  • Phone: 901-276-2410
  • Fax: 901-261-6010
Mailing address:
  • Phone: 901-227-7015
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33487
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: