Provider Demographics
NPI:1073959060
Name:EPPS, KATYANA LASHELLE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:KATYANA
Middle Name:LASHELLE
Last Name:EPPS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MS
Other - First Name:KATYANA
Other - Middle Name:LASHELLE
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:665 WINDSOR GREEN BLVD #F
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072
Mailing Address - Country:US
Mailing Address - Phone:901-652-8056
Mailing Address - Fax:
Practice Address - Street 1:3938 WINWOOD DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-6731
Practice Address - Country:US
Practice Address - Phone:901-282-6831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113001781374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide