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GARNET HEALTH PROVIDER LLC
NPI 1336503564
Nurse Practitioner - Acute Care in Memphis, TN

Active since April 13, 2016
4493 POTTERS CROSS DR, MEMPHIS, TN 38125(901) 336-8486 Get Directions Write a Review

NPPES record last updated: July 27, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Garnet Health Provider Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARNET HEALTH PROVIDER LLC (NPI 1336503564) is a healthcare organization registered as an acute care in Memphis, Tennessee and active in the NPI registry since April 2016. The organization lists Liesl R Bullen, Sole Member/provider, as its authorized official.

NPPES Registry Identity

NPI1336503564
Entity TypeOrganization
Primary Taxonomy363LA2100X
Legal Business NameGARNET HEALTH PROVIDER LLC
Location Address4493 POTTERS CROSS DRMemphis, TN 38125-4421
Mailing AddressPo Box 381531Germantown, TN 38183-1531 · (901) 417-1779
Phone(901) 336-8486
Organization SubpartNo
Authorized OfficialLiesl R BullenSole Member/provider · (901) 758-0280
Enumeration DateApril 13, 2016
Last NPPES UpdateJuly 27, 2016
✔ NPI 1336503564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TN · 11962
4493 POTTERS CROSS DR, Memphis, TN 38125
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Other Identifiers 2

Medicare PIN103G705244TN
MedicaidQ020954TN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Garnet Health Provider LLC's NPI number?

The NPI number for Garnet Health Provider LLC is 1336503564. It was assigned to this organization in the NPPES registry on April 13, 2016.

Where is Garnet Health Provider LLC located?

Garnet Health Provider LLC is located at 4493 Potters Cross Dr, Memphis, TN 38125. The listed phone number is (901) 336-8486.

What is Garnet Health Provider LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

When was this NPI record last updated?

The NPPES record for Garnet Health Provider LLC was last updated on July 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.