Provider Demographics
NPI:1770193344
Name:PASS, JAMES ANTHONY JR (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:PASS
Suffix:JR
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 SCHEIBLER RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-4906
Mailing Address - Country:US
Mailing Address - Phone:901-314-3994
Mailing Address - Fax:
Practice Address - Street 1:765 WOODLAND TRACE LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6609
Practice Address - Country:US
Practice Address - Phone:901-626-3515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily