Provider Demographics
NPI:1871384917
Name:ESSARY LANE, CATHY (SPE, HSP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:ESSARY LANE
Suffix:
Gender:F
Credentials:SPE, HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1478 WOLF BEND RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2303
Mailing Address - Country:US
Mailing Address - Phone:901-647-5100
Mailing Address - Fax:901-647-5100
Practice Address - Street 1:3059 FOREST HILL IRENE RD STE 104
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7808
Practice Address - Country:US
Practice Address - Phone:901-646-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE1187174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist