NPI Code Details Logo

NPI 1215879895

NPI 1215879895 : REZEALIANT MINDS, LLC : MEMPHIS, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1215879895
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    REZEALIANT MINDS, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/06/2026
-----------------------------------------------------
    Last Update Date     |    04/06/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8295 TOURNAMENT DR SUITE 150 
-----------------------------------------------------
    City                 |    MEMPHIS
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    38125
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    901-668-5550
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1910 MADISON AVE # 2200 
-----------------------------------------------------
    City                 |    MEMPHIS
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    38104-2620
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    NURSE PRACTITIONER
-----------------------------------------------------
    Name                 |     ANTOINETTE  FLOWERS 
-----------------------------------------------------
    Credential           |    PMHNP-BC
-----------------------------------------------------
    Telephone            |    901-668-5550
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.