Provider Demographics
NPI:1407598550
Name:SHOLAR-CONARD, TAMIEKA J (APRN)
Entity type:Individual
Prefix:
First Name:TAMIEKA
Middle Name:J
Last Name:SHOLAR-CONARD
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:SHOLAR-CONARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:4800 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-7437
Mailing Address - Country:US
Mailing Address - Phone:901-859-6552
Mailing Address - Fax:
Practice Address - Street 1:435 METROPLEX DR STE 211
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3109
Practice Address - Country:US
Practice Address - Phone:901-682-8150
Practice Address - Fax:866-635-1448
Is Sole Proprietor?:No
Enumeration Date:2022-04-10
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174977163WP0808X
TN35312363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health