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Organization

THE UNIVERSITY OF MEMPHIS

Active
Parent organization
THE UNIVERSITY OF MEMPHIS
Other names
Memphis Community Health Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE UNIVERSITY OF MEMPHIS
Authorized official
DR. BRADLEY R HARRELL DNP, APRN, ACNP-BC (ASSISTANT DEAN)
(901) 678-2003
Entity
Organization

Contact information

Practice address
4055 N PARK LOOP STE 1500, MEMPHIS, TN 38152-4220
(901) 678-2003
Mailing address
4055 N PARK LOOP STE 2502, MEMPHIS, TN 38152-4220
(901) 678-2003

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
251J00000X
Nursing Care Agency
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center
261QP2300X
Primary Care Clinic/Center
261QR1100X
Research Clinic/Center
261QS1000X
Student Health Clinic/Center
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
10/14/2024
Last updated
02/12/2025
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