Tearessie Donshi Archie
Individual provider Active NPI Driver · Memphis, TN
NPI 1801301296 · NPPES record last updated Dec 6, 2017
Key facts
- NPI
- 1801301296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 170006544 (TN)
- Practice address
- 4064 Royalcrest Dr
Memphis, TN 38115-6438 - Phone
- (901) 421-0032
- NPI assigned
- Dec 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170006544 | TN | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 170006544 | TN | Yes |
Addresses
Primary practice location
4064 Royalcrest Dr
Memphis, TN 38115-6438
Mailing address
4064 Royalcrest Dr
Memphis, TN 38115-6438
Phone (901) 421-0032
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.