Organization
KEJAC VENTURES, PLLC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEELLON LOUISE MARTIN NP (NURSE PRACTITIONER)
(901) 849-4108
Entity
Organization
Contact information
Practice address
9390 MAYFIELD RD S, COLLIERVILLE, TN 38017-3354
(901) 849-4108
Mailing address
9390 MAYFIELD RD S, COLLIERVILLE, TN 38017-3354
(901) 849-4108
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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