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General NPI Number Information
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NPI Number | 1700720059
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Entity Type | Organization
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Legal Business Name | ROANE PRIMARY CARE AND FAMILY MEDICINE
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 4913 RALEIGH COMMON DR STE 201
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City | MEMPHIS
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State | TN
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Zip | 38128-2485
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Country | US
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Telephone | 901-692-8014
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Fax |
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Provider Business Mailing Address
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Address Line | 4913 RALEIGH COMMON DR STE 201
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City | MEMPHIS
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State | TN
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Zip | 38128-2485
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Country | US
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Telephone | 901-692-8014
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. SHAUNTA LEA ROANE
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Credential | DNP-FNP-C
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Telephone | 901-692-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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