Provider Demographics
NPI:1316581150
Name:FRANKLIN-WILLIAMS, TAMMY
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:FRANKLIN-WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 FINLEY RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6940
Mailing Address - Country:US
Mailing Address - Phone:901-552-8346
Mailing Address - Fax:
Practice Address - Street 1:3525 RIDGE MEADOW PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4041
Practice Address - Country:US
Practice Address - Phone:901-602-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000268364SH1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolisticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNACU0000000268Medicaid