Healthcare Provider Details

I. General information

NPI: 1164570933
Provider Name (Legal Business Name): HOUSE CALL PRACTIONERS OF TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 FAIRBROOK AVE
MEMPHIS TN
38118-2533
US

IV. Provider business mailing address

5155 FAIRBROOK AVE
MEMPHIS TN
38118-2533
US

V. Phone/Fax

Practice location:
  • Phone: 901-438-8241
  • Fax:
Mailing address:
  • Phone: 901-438-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. STACY JONES
Title or Position: OWNER MANAGER
Credential:
Phone: 901-438-8241