Individual
JACKIE IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4095 AMERICAN WAY STE 1, MEMPHIS, TN 38118-8339
(901) 302-4363
(865) 342-0130
Mailing address
1923 SULPHUR SPRINGS RD, MORRISTOWN, TN 37813-5654
(423) 317-9344
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
215882
TN
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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