Breyocha Dewalt, NP
Nurse Practitioner, Acute Care in Memphis, TN. Individual provider (NPI-1).
NPI number1548045263
StatusActive
Last updated in NPPESSep 20, 2023
Details
- NPI
- 1548045263
- Entity type
- Individual (NPI-1)
- Name
- Breyocha Dewalt
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 30, 2023
- Certification date
- Sep 20, 2023
- Last updated
- Sep 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 34590 | TN | Yes |
| 163WC0200X | Registered Nurse, Critical Care Medicine | 0000223825 | TN |
Other names
- Breyocha Mays (Former Name)
Practice location
1211 Union Ave Ste 965Memphis, TN 38104-6638
Phone 901-435-8550 · Fax 901-478-0781
Mailing address
Po Box 1000, Dept 960Memphis, TN 38148-0001
Phone 901-758-9900 · Fax 901-752-2335
Other practice locations
1251 Wesley Dr Ste 153
Memphis, TN 38116-6443
Memphis, TN 38116-6443
Phone 901-435-8550 · Fax 901-395-2621
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