Organization
SELENE INTEGRATIVE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE JACKSON DNP, FNP-C (NURSE PRACTITIONER/ OWNER)
(901) 361-6822
Entity
Organization
Contact information
Practice address
109 W DEMPSTER AVE, MEMPHIS, TN 38109
(901) 361-6822
Mailing address
555 S B B KING BLVD UNIT 1341, MEMPHIS, TN 38101-1057
(901) 361-6822
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
261QH0100X
Health Service Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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