Individual
JACK CHANDLER PAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7655 POPLAR AVE STE 350, GERMANTOWN, TN 38138-4933
(901) 761-2470
(901) 767-4898
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28410
TN
363LF0000X
Family Nurse Practitioner
28410
TN
363LF0000X
Family Nurse Practitioner
904282
MS
363LF0000X
Family Nurse Practitioner
PAPA-03IX09
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
904282
MS LICENSE
MS
05
—
APN0000028410
—
TN
Enumeration date
09/26/2020
Last updated
01/10/2024
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