MEDICARE: MS. MICHELLE L SCROGGINS APN

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	163W00000X	Registered Nurse	129653	TN
2	363LA2100X	Acute Care Nurse Practitioner	11088	TN
3	363LF0000X	Family Nurse Practitioner	11088	TN

General Provider Information

NPI Number	:	1215939350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE L SCROGGINS APN

Provider Business Mailing Address
First Line	:	1211 UNION AVE STE 330
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-6655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 NEW COVINGTON PIKE STE 220
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38128-2595
Country	:	US
Telephone Number	:	901-763-0200
Fax Number	:	901-516-5370

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/20/2025

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