=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194617274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APC HOLDINGS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2025
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2747 KIRBY RD
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38119-8236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-203-0750
-----------------------------------------------------
Fax | 901-203-0354
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 681029
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37068-1029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-253-1110
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR, CREDENTIALING/ENROLLMENT
-----------------------------------------------------
Name | MELISSA HARLAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-948-9639
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------