Provider Demographics
NPI:1043779010
Name:STENNIS, DONCHITA V
Entity Type:Individual
Prefix:MS
First Name:DONCHITA
Middle Name:V
Last Name:STENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 KIRBY PKWY # 1-106
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3666
Mailing Address - Country:US
Mailing Address - Phone:901-949-5278
Mailing Address - Fax:
Practice Address - Street 1:10131 CAMERON RIDGE TRL
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-7184
Practice Address - Country:US
Practice Address - Phone:901-949-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health