MRS. DALLAS PROVENCE, NP
Dermatology - Dermatopathology
Active
Individual
NPI: 1619556230
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dermatology - Dermatopathology | 207ND0900X | Yes | 28973 (TN) |
Frequently Asked Questions
NPI 1619556230 is the National Provider Identifier for MRS. DALLAS PROVENCE, NP, a Dermatology - Dermatopathology provider located in Memphis, TN. This NPI was enumerated on April 2, 2021.
MRS. DALLAS PROVENCE, NP practices at 6254 POPLAR AVE, Memphis, TN 38119.
Quick Facts
- NPI
- 1619556230
- Type
- Individual
- Enumerated
- Apr 2, 2021
- Last Updated
- Apr 2, 2021
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