Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 45429 | TN |
N | 111NI0900X | Internist | 45429 | TN |
N | 208000000X | Pediatrician | 45429 | TN |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 45429 | TN |
NPI | 1235356544 |
---|---|
Provider Name | Dr. Kerri Nottage |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 06/09/2011 |