Basic Information
Provider Information
NPI: 1740280924
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HESS
FirstName: PATRICIA
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 850 POPLAR AVE BLDG 2
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381054607
CountryCode: US
TelephoneNumber: 9012875565
FaxNumber: 9012876804
Practice Location
Address1: 51 N DUNLAP ST STE 400
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381054625
CountryCode: US
TelephoneNumber: 9012877337
FaxNumber: 9012876337
Other Information
ProviderEnumerationDate: 07/28/2005
LastUpdateDate: 01/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X6053TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LP0222X6053TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
163W00000X70237TNN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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