Provider Demographics
NPI:1598350746
Name:ALMOND, MANDY KAY (FNP)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:KAY
Last Name:ALMOND
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 1:2055 OLD LAKE PIKE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5519
Mailing Address - Country:US
Mailing Address - Phone:901-282-6046
Mailing Address - Fax:
Practice Address - Street 1:2055 OLD LAKE PIKE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5519
Practice Address - Country:US
Practice Address - Phone:901-282-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000029090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000029090OtherTENNESSEE BOARD OF NURSING