Individual
TANNISHA MONIQUE LOGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-2980
(662) 772-2960
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902664
MS
Other
Enumeration date
09/07/2018
Last updated
11/19/2019
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