Basic Information
| Provider Information | |||||||||
| NPI: | 1275564866 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS-THARPE | ||||||||
| FirstName: | VERNESSA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 POPLAR AVE BLDG 2 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381054607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012875594 | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 SKYLINE DR FL 3 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383013923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668705570 | ||||||||
| FaxNumber: | 7315418187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 05/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 21682 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 21682 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 208000000X | 21682 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.