Provider Demographics
NPI:1285044479
Name:ADAMS, LANITRA YVONNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LANITRA
Middle Name:YVONNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12321 LONGHORN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8793
Mailing Address - Country:US
Mailing Address - Phone:901-305-7144
Mailing Address - Fax:
Practice Address - Street 1:438 N CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7014
Practice Address - Country:US
Practice Address - Phone:901-545-2279
Practice Address - Fax:888-905-2546
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily