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NPI Code Detail

MEDICARE: MRS. LORETTA LAMBERT SHAMLEY APN-BC, FNP

MEDICARE: MRS. LORETTA LAMBERT SHAMLEY APN-BC, 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 PractitionerA003321AR
2363LF0000XFamily Nurse Practitioner13791TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1103G702703OTHERTNGROUP MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21750514410OTHERTNGROU NPI

General Provider Information

NPI Number : 1770728784
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORETTA LAMBERT SHAMLEY APN-BC, FNP
Provider Business Mailing Address
First Line : 6799 GREAT OAKS RD
Second Line : STE 150
City : MEMPHIS
State : TN
Zip : 38138-2514
Country : US
Telephone Number : 901-227-3255
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 1936 W POPLAR AVE
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-0605
Country : US
Telephone Number : 901-853-6012
Fax Number : 901-853-6069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2008
Last Update Date : 05/18/2022

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