MEDICARE: BRITTANEY LENAE' GILLESPIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	911101	MS

General Provider Information

NPI Number	:	1144175613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANEY LENAE' GILLESPIE

Provider Business Mailing Address
First Line	:	1727 KIRBY PKWY STE 100
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-4335
Country	:	US
Telephone Number	:	901-685-5520
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 KIRBY PKWY STE 100
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-4335
Country	:	US
Telephone Number	:	901-685-5520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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