Provider Demographics
NPI:1306459516
Name:INMAN, VLADYSLAVA (DNP)
Entity type:Individual
Prefix:DR
First Name:VLADYSLAVA
Middle Name:
Last Name:INMAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:VLADA
Other - Middle Name:
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:6645 AQUILA CIR W
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-9220
Mailing Address - Country:US
Mailing Address - Phone:901-606-4795
Mailing Address - Fax:
Practice Address - Street 1:1265 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-516-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28118363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty