Individual
CAITLIN MORAN BROCKENSHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6325 HUMPHREYS BLVD, MEMPHIS, TN 38120-2300
(901) 522-7700
(901) 522-2600
Mailing address
6325 HUMPHREYS BLVD, MEMPHIS, TN 38120-2300
(901) 522-7700
(901) 522-2600
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
33205
MS
2084N0400X
Neurology Physician
Primary
67573
TN
2084V0102X
Vascular Neurology Physician
67573
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200010535
—
MS
05
—
Q050407
—
TN
Enumeration date
04/17/2019
Last updated
07/17/2024
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