Provider Demographics
NPI:1629752456
Name:ELITE SCREENING AND WELLNESS
Entity Type:Organization
Organization Name:ELITE SCREENING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:901-237-7619
Mailing Address - Street 1:6166 E SHELBY DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-7701
Mailing Address - Country:US
Mailing Address - Phone:901-236-7619
Mailing Address - Fax:901-310-4658
Practice Address - Street 1:6166 E SHELBY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-7701
Practice Address - Country:US
Practice Address - Phone:901-236-7619
Practice Address - Fax:901-310-4658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty