Provider Demographics
NPI:1528897709
Name:MATHIS, KAMRI (MSN,APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KAMRI
Middle Name:
Last Name:MATHIS
Suffix:
Gender:F
Credentials:MSN,APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 IRONWOOD CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3029
Mailing Address - Country:US
Mailing Address - Phone:901-376-9632
Mailing Address - Fax:
Practice Address - Street 1:4041 KNIGHT ARNOLD RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2128
Practice Address - Country:US
Practice Address - Phone:901-572-1573
Practice Address - Fax:901-360-0865
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000035916363LF0000X
TN0000227596163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily