Healthcare Provider Details

I. General information

NPI: 1932045242
Provider Name (Legal Business Name): TAYLOR BURRESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 MADISON AVE
MEMPHIS TN
38103-3408
US

IV. Provider business mailing address

424 ITAWAMBA RD
COLLIERVILLE TN
38017-3589
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-6036
  • Fax:
Mailing address:
  • Phone: 901-214-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: