Healthcare Provider Details

I. General information

NPI: 1922307768
Provider Name (Legal Business Name): MELANIE KRA'SHAWNA LEFLORE-FIFER NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 UNION AVE
MEMPHIS TN
38104-3415
US

IV. Provider business mailing address

4755 WHITE PASS DR
COLLIERVILLE TN
38017-3461
US

V. Phone/Fax

Practice location:
  • Phone: 901-516-7600
  • Fax: 901-516-8394
Mailing address:
  • Phone: 901-628-3934
  • Fax: 901-861-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15493
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: