Provider Demographics
NPI:1447968623
Name:LEE-JOHNSON, TERRI N (CPM)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:N
Last Name:LEE-JOHNSON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 EASTERN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-2610
Mailing Address - Country:US
Mailing Address - Phone:901-219-5417
Mailing Address - Fax:
Practice Address - Street 1:781 EASTERN DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-2610
Practice Address - Country:US
Practice Address - Phone:901-219-5417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife