Individual provider Active NPI

Memory Denise Luttrell

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1043120066
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1216202 Issued in TX
Practice address
802 Turtle Creek Dr
Tyler, TX 75701-1900
Phone
(903) 595-4333
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1216202 TX Primary

Addresses

Primary practice location

802 Turtle Creek Dr
Tyler, TX 75701-1900

Mailing address

802 Turtle Creek Dr
Tyler, TX 75701-1900
Phone (903) 595-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1043120066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011900",
            "telephone_number": "903-595-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011900",
            "telephone_number": "903-595-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTRELL",
        "first_name": "MEMORY",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1216202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.