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General NPI Number Information
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NPI Number | 1033223599
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Entity Type | Individual
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Provider Name | CLAIRE C ELLENDER PAC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 7655 POPLAR AVE STE 240
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City | GERMANTOWN
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State | TN
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Zip | 38138-3957
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Country | US
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Telephone | 901-758-7970
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Fax | 901-266-6425
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Provider Business Mailing Address
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Address Line | 1211 UNION AVE STE 330
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City | MEMPHIS
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State | TN
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Zip | 38104-6655
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-305
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00176
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1314
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1314
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License Number State | TN
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