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General NPI Number Information
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NPI Number | 1578916193
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Entity Type | Individual
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Provider Name | LISA VANHOUWELINGEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 262 DANNY THOMAS PL MAIL STOP 741
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City | MEMPHIS
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State | TN
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Zip | 38105-3678
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Country | US
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Telephone | 901-595-2882
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Fax | 901-595-3105
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Provider Business Mailing Address
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Address Line | 1495 GROVE MEADOW CT
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City | GERMANTOWN
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State | TN
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Zip | 38138-3308
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Country | US
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Telephone | 901-618-4343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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