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General NPI Number Information
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NPI Number | 1689895245
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Entity Type | Individual
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Provider Name | JUSTIN D MCADOO DNP, CRNA, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 6373 N QUAIL HOLLOW RD STE 101
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City | MEMPHIS
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State | TN
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Zip | 38120-1405
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Country | US
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Telephone | 901-871-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 6373 N QUAIL HOLLOW RD STE 101
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City | MEMPHIS
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State | TN
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Zip | 38120-1405
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Country | US
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Telephone | 901-871-0170
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 141683
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 225137
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 906011
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C003113
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License Number State | AR
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 12785
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 901353
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License Number State | MS
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12785
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License Number State | TN
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