Individual
ROBERT DECOLLI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
7460 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1760
(901) 763-0200
(901) 761-4002
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
31566
TN
363L00000X
Nurse Practitioner
906328
MS
363L00000X
Nurse Practitioner
SP021499
PA
Other
Enumeration date
02/11/2020
Last updated
01/16/2024
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