Individual
MRS. TANIA L ADDESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-2162
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-2162
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7586
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114417
RN LICENSE
TN
01
—
7586
APN TN LICENSE
TN
Enumeration date
11/09/2010
Last updated
11/09/2010
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