Organization
J WILSON HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUITA A STARKS PMHNP-BC, FNP-C (OWNER OF ENTITY)
(901) 235-0957
Entity
Organization
Contact information
Practice address
5100 POPLAR AVE, FL 27 STE 2719A, MEMPHIS, TN 38137-2701
(901) 235-0957
Mailing address
5100 POPLAR AVE, FL 27 STE 2719A, MEMPHIS, TN 38137-2701
(901) 235-0957
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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