Individual
DETRICE FLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
125 GAYOSO AVE APT 504, MEMPHIS, TN 38103-2918
(731) 217-6636
Mailing address
125 GAYOSO AVE APT 504, MEMPHIS, TN 38103-2918
(731) 217-6636
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
33892
TN
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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