Provider Demographics
NPI:1750753695
Name:ROSS, TOMISHA V (FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:TOMISHA
Middle Name:V
Last Name:ROSS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TOMISHA
Other - Middle Name:
Other - Last Name:BYARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:877 JEFFERSON AVE
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:718 HABOR BEND ROAD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103
Practice Address - Country:US
Practice Address - Phone:901-515-4200
Practice Address - Fax:901-515-4239
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily