Christopher Gully, NP
Nurse Practitioner, Gerontology in Southaven, MS. Individual provider (NPI-1).
NPI number1013778596
StatusActive
Last updated in NPPESJun 24, 2024
Details
- NPI
- 1013778596
- Entity type
- Individual (NPI-1)
- Name
- Christopher Gully
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 22, 2024
- Certification date
- Jun 24, 2024
- Last updated
- Jun 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 906487 | MS | Yes |
| 363LF0000X | Nurse Practitioner, Family | 3555 | TN |
Practice location
363 Southcrest Cir Ste 202Southaven, MS 38671-4737
Phone 901-226-0456 · Fax 901-226-0458
Mailing address
965 Ridge Lake Blvd Ste 315Memphis, TN 38120-9401
Phone 877-348-1281 · Fax 901-227-3206
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