Individual
MARILEE SUZANNE STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 PEABODY AVE, MEMPHIS, TN 38104-4506
(901) 707-6861
Mailing address
1448 HAYNE RD, MEMPHIS, TN 38119-5925
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
29200
TN
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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