Healthcare Provider Details

I. General information

NPI: 1316784838
Provider Name (Legal Business Name): CAROLINE-CAMILLA SAUNDERS HALSTEAD APRN, CPNP-PC, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3703 PARK AVE
NASHVILLE TN
37209-3738
US

IV. Provider business mailing address

649 PHILADELPHIA ST
MEMPHIS TN
38104-5543
US

V. Phone/Fax

Practice location:
  • Phone: 901-728-5858
  • Fax:
Mailing address:
  • Phone: 901-728-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number35132
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: