=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134073034
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELITE MOBILE WOUND CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2026
-----------------------------------------------------
Last Update Date | 02/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3173 KIRBY WHITTEN RD STE 106
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38134-2881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-219-9559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3172 TIPPAH CV
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38119-9166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-618-9708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NNEKA DANIELS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 901-618-9708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------