Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 47968 | TN |
Y | 207VX0000X | Obstetrician | 47968 | TN |
NPI | 1255588950 |
---|---|
Provider Name | Dr. Kendra Deonne Hayslett |
First Address | Memphis, TN 38120-9446 |
Second Address | Martin, TN 38237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2008 |
Last Update Date | 29/06/2018 |