Provider Demographics
NPI:1598866568
Name:NEIRA, CLAUDIA P (FNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:P
Last Name:NEIRA
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 1:6063 MT MORIAH RD EXT
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2644
Mailing Address - Country:US
Mailing Address - Phone:901-531-8800
Mailing Address - Fax:901-531-8801
Practice Address - Street 1:1068 CRESTHAVEN RD STE 300
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0809
Practice Address - Country:US
Practice Address - Phone:901-683-0024
Practice Address - Fax:901-683-0086
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN8252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ1519873Medicaid
TN334703494Medicare ID - Type UnspecifiedMEDICARE NUMBER