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1427691823
ILIA BETHEA-GOLDEN
MEMPHIS, TN
NPI
1427691823
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 25982)
Enumeration Date
2019-10-18
Last Update Date
2019-10-18
Business Address
ILIA BETHEA-GOLDEN NP
877 JEFFERSON AVE
MEMPHIS, TN 38103-2807
Phone number: 901-545-8699
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Mailing Address
ILIA BETHEA-GOLDEN NP
877 JEFFERSON AVENUE ATTN: PROVIDER ENROLLMENT
MEMPHIS, TN 38103
Phone number:
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