Individual
TIA LAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7100
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-8336
(901) 545-8122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
19107
TN
363LF0000X
Family Nurse Practitioner
19107
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19107
TN
Other
Enumeration date
09/09/2014
Last updated
11/15/2019
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