Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 60999 | TN |
NPI | 1861897241 |
---|---|
Provider Name | Kerri Bosfield |
First Address | Memphis, TN 38103-2802 |
Second Address | Memphis, TN 38105-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 01/09/2020 |