Organization
SHOT NURSE-MEMPHIS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH YVONNE OVERALL RN (VICE-PRESIDENT)
(901) 685-9999
Entity
Organization
Contact information
Practice address
4637 POPLAR AVE, MEMPHIS, TN 38117-4419
(901) 685-9999
(901) 767-8388
Mailing address
4637 POPLAR AVE, MEMPHIS, TN 38117-4419
(901) 685-9999
(901) 767-8388
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
07/24/2014
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