MEDICARE: CAVITA KAPADIA RN

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	217699	TN

General Provider Information

NPI Number	:	1598580631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAVITA KAPADIA RN

Provider Business Mailing Address
First Line	:	1113 DEARING RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-5509
Country	:	US
Telephone Number	:	901-849-3741
Fax Number	:

Provider Business Practice Location Address
First Line	:	4564 WARDEN RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-4120
Country	:	US
Telephone Number	:	901-849-3741
Fax Number	:

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

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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