Provider Demographics
NPI:1124569918
Name:HUMILITY HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:HUMILITY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-305-0878
Mailing Address - Street 1:PO BOX 750188
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38175-0188
Mailing Address - Country:US
Mailing Address - Phone:901-305-0878
Mailing Address - Fax:
Practice Address - Street 1:6716 BROWNBARK CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4302
Practice Address - Country:US
Practice Address - Phone:901-305-0878
Practice Address - Fax:901-370-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN16133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty