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General NPI Number Information
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NPI Number | 1083436505
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PEDIATRIC AND FAMILY CLINIC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1028 CRESTHAVEN RD STE 100
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City | MEMPHIS
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State | TN
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Zip | 38119-3895
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Country | US
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Telephone | 901-249-7490
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 CRESTHAVEN RD STE 100
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City | MEMPHIS
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State | TN
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Zip | 38119-3895
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Country | US
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Telephone | 901-249-7490
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | DR. STELLA NWOKEJI
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Credential | PHD, NP-BC
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Telephone | 901-826-4622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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