| Wound Management Specialists Tn Pllc | |
|
6584 Poplar Ave Ste 212 Memphis TN 38138-3687 | |
| (769) 239-3792 | |
| Not Available |
| Full Name | Wound Management Specialists Tn Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6584 Poplar Ave Ste 212, Memphis, Tennessee |
| Authorized Official Name and Position | Thomas Mcmahon (CEO) |
| Authorized Official Contact | 7692436141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Management Specialists Tn Pllc 778 Liberty Rd Flowood MS 39232-9321 Ph: (769) 243-6141 | Wound Management Specialists Tn Pllc 6584 Poplar Ave Ste 212 Memphis TN 38138-3687 Ph: (769) 239-3792 |
| NPI Number | 1588394100 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 09/21/2022 |
| Medicare PECOS PAC ID | 5294102521 |
|---|---|
| Medicare Enrollment ID | O20221031000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588394100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Hurlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548263296 PECOS PAC ID: 5890758452 Enrollment ID: I20041105000174 |
| Provider Name | Kelly A Mundy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427228816 PECOS PAC ID: 7911078092 Enrollment ID: I20130612000244 |
| Provider Name | Allison Rey Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710369954 PECOS PAC ID: 5092029512 Enrollment ID: I20150728005743 |
| Provider Name | Celena Lanette Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205499019 PECOS PAC ID: 8426382961 Enrollment ID: I20190703000064 |
| Provider Name | Lori Mcmahan Stepp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801397096 PECOS PAC ID: 5193087146 Enrollment ID: I20191112001256 |
| Provider Name | Nikolaus P King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780279448 PECOS PAC ID: 0446521538 Enrollment ID: I20210621001938 |
| Provider Name | Meredith N Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144898057 PECOS PAC ID: 5193127967 Enrollment ID: I20210715003619 |
| Provider Name | Tiffany Chynnell Tenort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396315156 PECOS PAC ID: 8628329943 Enrollment ID: I20211001001032 |
| Provider Name | Angela Bearden Alsbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821738972 PECOS PAC ID: 0840687075 Enrollment ID: I20220418001987 |
| Provider Name | Nathaniel Bump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003449398 PECOS PAC ID: 9335562644 Enrollment ID: I20221104001914 |
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