Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD041170 | DC |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 60227 | TN |
NPI | 1265756712 |
---|---|
Provider Name | Lauren Patricia Jerkins |
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 | 25/03/2010 |
Last Update Date | 18/11/2019 |