Individual
KIMBERLY SHARESE TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
6522 BAYBROOK LN, MEMPHIS, TN 38134-7802
(662) 571-0393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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