Individual
KISHA PICKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-5000
Mailing address
PO BOX 634760, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN7033
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02332770
—
MS
05
—
3906164
—
TN
01
—
4010530
BLUE CROSS
TN
Enumeration date
05/27/2006
Last updated
12/05/2007
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