Organization
UT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN MUIRHEAD NNP-BC (NEONATAL NURSE PRACTITIONER)
(901) 545-7366
Entity
Organization
Contact information
Practice address
853 JEFFERSON AVE, ROOM 201, MEMPHIS, TN 38103-2807
(901) 545-7366
Mailing address
179 EASTLAND DR, MEMPHIS, TN 38111-6930
(901) 761-2979
Taxonomy
Speciality
Code
Description
License number
State
282NW0100X
Women's Hospital
Primary
8199402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8198662
ADVANCED PRACTICE LIICENSE
TN
Enumeration date
09/05/2012
Last updated
09/05/2012
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