MEDICARE: TAMIEKA J SHOLAR-CONARD APRN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	174977	TN
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	35312	TN

General Provider Information

NPI Number	:	1407598550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMIEKA J SHOLAR-CONARD APRN

Provider Business Mailing Address
First Line	:	4800 HERITAGE DR
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-7437
Country	:	US
Telephone Number	:	901-859-6552
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 METROPLEX DR STE 211
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3109
Country	:	US
Telephone Number	:	901-682-8150
Fax Number	:	866-635-1448

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

Provider Enumeration Date	:	04/10/2022
Last Update Date	:	02/28/2025

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