Provider Demographics
NPI:1770728784
Name:SHAMLEY, LORETTA LAMBERT (APN-BC, FNP)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:LAMBERT
Last Name:SHAMLEY
Suffix:
Gender:F
Credentials:APN-BC, FNP
Other - Prefix:MS
Other - First Name:LORETTA
Other - Middle Name:
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6799 GREAT OAKS RD
Mailing Address - Street 2:STE 150
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2514
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:1936 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0605
Practice Address - Country:US
Practice Address - Phone:901-853-6012
Practice Address - Fax:901-853-6069
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003321363LF0000X
TN13791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G702703OtherGROUP MEDICARE PTAN
TN1750514410OtherGROU NPI