Provider Demographics
NPI:1679195010
Name:NEE, CARALYNA
Entity Type:Individual
Prefix:
First Name:CARALYNA
Middle Name:
Last Name:NEE
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 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5754
Mailing Address - Country:US
Mailing Address - Phone:901-259-1600
Mailing Address - Fax:901-259-1698
Practice Address - Street 1:6286 BRIARCREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4023
Practice Address - Country:US
Practice Address - Phone:901-259-1600
Practice Address - Fax:901-259-1698
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS668363AM0700X, 363AS0400X, 363AS0400X
TN5126363AM0700X, 363AS0400X, 363AS0400X
MS363AS0400X
TN363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical