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NPI Code Detail

MEDICARE: MRS. CAROLYN IJAMS SPEROS FNP

MEDICARE: MRS. CAROLYN IJAMS SPEROS FNP
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
1363LF0000XFamily Nurse PractitionerAPN5133TN
2363LF0000XFamily Nurse PractitionerRN32647TN

General Provider Information

NPI Number : 1518976455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN IJAMS SPEROS FNP
Provider Business Mailing Address
First Line : P.O. BOX 405827
Second Line :
City : ATLANTA
State : GA
Zip : 30384-5827
Country : US
Telephone Number : 870-934-5821
Fax Number : 870-934-5384
Provider Business Practice Location Address
First Line : 5220 PARK AVENUE
Second Line : SUITE 100
City : MEMPHIS
State : TN
Zip : 38119-3500
Country : US
Telephone Number : 901-685-8245
Fax Number : 901-685-8248
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 06/26/2012

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