Individual
SUE STOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6005 PARK AVE, SUITE 630B, MEMPHIS, TN 38119-5202
(901) 767-1136
(901) 767-0476
Mailing address
6005 PARK AVE, SUITE 630B, MEMPHIS, TN 38119-5202
(901) 767-1136
(901) 767-0476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
45107
TN
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
45107
TN
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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