Provider Demographics
NPI:1164570933
Name:HOUSE CALL PRACTIONERS OF TENNESSEE LLC
Entity Type:Organization
Organization Name:HOUSE CALL PRACTIONERS OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-438-8241
Mailing Address - Street 1:5155 FAIRBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-2533
Mailing Address - Country:US
Mailing Address - Phone:901-438-8241
Mailing Address - Fax:
Practice Address - Street 1:5155 FAIRBROOK AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2533
Practice Address - Country:US
Practice Address - Phone:901-438-8241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty