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General NPI Number Information
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NPI Number | 1639209810
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Entity Type | Individual
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Provider Name | PATRICE OWENS ANDERSON FNP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 116 N PAULINE ST
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City | MEMPHIS
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State | TN
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Zip | 38104-1005
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Country | US
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Telephone | 901-523-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 3615 HERMITAGE DR
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City | MEMPHIS
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State | TN
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Zip | 38116-4351
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Country | US
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Telephone | 901-314-4294
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12814
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 91982
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License Number State | TN
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