Organization
FARRIS PEDIATRIC PRIMARY CARE CONCEPT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE FARRIS PPCNP-BC (PEDIATRIC NURSE PRACTITIONER)
(901) 409-0506
Entity
Organization
Contact information
Practice address
4250 FARONIA RD STE 2A, MEMPHIS, TN 38116-6250
(901) 236-7707
Mailing address
2059 KINGSLEY AVE, MEMPHIS, TN 38127-3933
(901) 409-0506
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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