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General NPI Number Information
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NPI Number | 1912739913
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Entity Type | Individual
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Provider Name | KISHA DENISE DOEBLER PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/17/2024
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 4646 POPLAR AVE STE 302
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City | MEMPHIS
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State | TN
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Zip | 38117
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Country | US
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Telephone | 901-930-7397
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Fax | 901-585-0874
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Provider Business Mailing Address
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Address Line | 4646 POPLAR AVE STE 302
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City | MEMPHIS
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State | TN
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Zip | 38117-4433
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Country | US
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Telephone | 901-930-7397
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024027472
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License Number State | TN
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