Provider Demographics
NPI:1245837533
Name:GARRISON, SANDRA DEE (APRN)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:DEE
Last Name:GARRISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 LILLIAN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-4431
Mailing Address - Country:US
Mailing Address - Phone:901-653-4136
Mailing Address - Fax:
Practice Address - Street 1:335 LILLIAN DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-4431
Practice Address - Country:US
Practice Address - Phone:901-653-4136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN03447713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily