Provider Demographics
NPI:1417660648
Name:TOTAL HEALTH PRIMARY CARE LLC
Entity Type:Organization
Organization Name:TOTAL HEALTH PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-336-2388
Mailing Address - Street 1:2966 ELMORE PARK RD UNIT 342745
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38184-0348
Mailing Address - Country:US
Mailing Address - Phone:901-336-2388
Mailing Address - Fax:901-590-0677
Practice Address - Street 1:8223 ROCKCREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016
Practice Address - Country:US
Practice Address - Phone:901-336-2388
Practice Address - Fax:901-590-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty