Provider Demographics
NPI:1366589830
Name:BORGOGNONI, KAYE W (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAYE
Middle Name:W
Last Name:BORGOGNONI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:SUITE 38
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-756-6056
Mailing Address - Fax:901-624-0702
Practice Address - Street 1:8071 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8206
Practice Address - Country:US
Practice Address - Phone:901-756-6056
Practice Address - Fax:901-624-0702
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily