Provider Demographics
NPI:1194263863
Name:WHITE, JOYCE LACEY (APRN)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:LACEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 1000
Mailing Address - Street 2:DEPT 978
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:8115 COUNTRY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2030
Practice Address - Country:US
Practice Address - Phone:901-752-2300
Practice Address - Fax:901-752-2348
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily