Individual
DEJA WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2569 DOUGLASS AVE, MEMPHIS, TN 38114-2532
(901) 842-3164
Mailing address
8860 PRESTANCIA CV S, MEMPHIS, TN 38125-1734
(901) 461-7045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1231052
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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