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CLAIRE C ELLENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
7655 POPLAR AVE STE 240, GERMANTOWN, TN 38138-3957
(901) 758-7970
(901) 266-6425
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1314
TN
363A00000X
Physician Assistant
PA-305
AR
363A00000X
Physician Assistant
PA00176
MS
363AS0400X
Surgical Physician Assistant
Primary
1314
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08010016600
QUAL CHOICE
AR
05
1523137
TN
01
P00426098
RAILROAD MEDICARE
AR
01
P01204970
RR MEDICARE TN
TN
Enumeration date
08/19/2006
Last updated
02/20/2025
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