Provider Demographics
NPI:1770678567
Name:LLOYD, KATHLEEN ANN (NPC APRN BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:NPC APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 NEW BYHALIA RD STE 3
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3741
Mailing Address - Country:US
Mailing Address - Phone:901-853-7134
Mailing Address - Fax:901-854-1166
Practice Address - Street 1:346 NEW BYHALIA RD STE 3
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3741
Practice Address - Country:US
Practice Address - Phone:901-853-1734
Practice Address - Fax:901-854-1166
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901476163W00000X
GARN056238NP363LF0000X
MS901395363LF0000X
TN22044363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000848999BMedicaid
GA50BBCQNMedicare ID - Type Unspecified
573805Medicare UPIN