Individual
LYNNETTE K PROKOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1325 EASTMORELAND AVE STE 310, MEMPHIS, TN 38104-7544
(901) 758-7970
(901) 266-6425
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
(901) 758-7970
(901) 266-6425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.004572RX
OH
363AS0400X
Surgical Physician Assistant
Primary
4968
TN
Other
Enumeration date
01/05/2016
Last updated
04/05/2022
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