Provider Demographics
NPI:1235310996
Name:STRONG, CSARA R (NP)
Entity Type:Individual
Prefix:
First Name:CSARA
Middle Name:R
Last Name:STRONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 UNION AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3513
Mailing Address - Country:US
Mailing Address - Phone:901-725-1785
Mailing Address - Fax:901-725-5264
Practice Address - Street 1:1331 UNION AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3513
Practice Address - Country:US
Practice Address - Phone:901-725-1785
Practice Address - Fax:901-725-5264
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12217363LF0000X
MSA810214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSA810214OtherMS LICENSE
TNAPN0000012217OtherTN APN LICENSE
AR175290758Medicaid
TN1511572Medicaid
MS05555217Medicaid
MS05555217Medicaid
TN1511572Medicaid
TNMS1504174OtherTN DEA
TNAPN0000012217OtherTN APN LICENSE