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DALLAS PROVENCE, NP

NP

Dermatopathology Physician

NPI: 1619556230IndividualAccepts Medicare

Specialties, Licenses & Credentials

Dermatopathology PhysicianPrimary

Dermatology — Dermatopathology

Code: 207ND0900X

28973(TN)

CMS Specialties

Education

OTHER

Class of 2020

Contact & Hours

Address
6254 POPLAR AVE
MEMPHIS, TN 38119

Quick Facts

NPI
1619556230
Entity Type
Individual
Gender
Female
Medicare
Accepted
Specialties
1
Locations
1
Years in Practice
6

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