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General NPI Number Information
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NPI Number | 1164956801
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Entity Type | Organization
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Legal Business Name | HEAVEN SENT CARE PLLC
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 3030 WALNUT GROVE RD
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City | MEMPHIS
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State | TN
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Zip | 38111-3508
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Country | US
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Telephone | 901-417-4442
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 750534
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City | MEMPHIS
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State | TN
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Zip | 38175-0534
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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 | FNP/OWNER
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Name | TYKIS ROBBINS
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Credential | FNP
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Telephone | 901-417-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN18495
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License Number State | TN
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