Provider Demographics
NPI:1295043693
Name:DRIVER, JAVINA SHENELL (RN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JAVINA
Middle Name:SHENELL
Last Name:DRIVER
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:MISS
Other - First Name:JAVINA
Other - Middle Name:SHENELL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PMHNP-BC
Mailing Address - Street 1:2150 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-6662
Mailing Address - Country:US
Mailing Address - Phone:901-353-5440
Mailing Address - Fax:
Practice Address - Street 1:65 GERMANTOWN CT STE 402
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4275
Practice Address - Country:US
Practice Address - Phone:901-752-4900
Practice Address - Fax:901-752-4902
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15263363LP0808X
TNRN0000172856163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse