| Lori B Holladay, FNP-BC | |
| 
					205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649  | |
| (731) 352-7907 | |
| (731) 352-4459 | 
| Full Name | Lori B Holladay | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 205 Hospital Dr, Mc Kenzie, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144644246 | NPI | - | NPPES | 
| Q003306 | Medicaid | TN | |
| 3380640 | Other | TN | MEDICAID GROUP | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APN18359 (Tennessee) | Primary | 
| Entity Name | Baptist Memorial Hospital-huntingdon | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1184114902 PECOS PAC ID: 4082509757 Enrollment ID: O20180927003364  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lori B Holladay, FNP-BC 965 Ridge Lake Blvd Ste 315, Memphis, TN 38120-9401 Ph: () -  | Lori B Holladay, FNP-BC 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 Ph: (731) 352-7907  | 
Beth Mitchell Graves, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 731-352-4459  | |
Mrs. Victoria Brooke Ivy, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1894 Cedar St, Mc Kenzie, TN 38201 Phone: 731-207-6496  | |
Gyu Chang Jo, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 205 Hospital Dr Ste A, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 731-352-4459  | |
Meredith Ann Brown, NP-C, CHPN, MSN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 731-352-4459  | |
Leslie Leeann Ellis, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 150 Oak Manor Rd, Mc Kenzie, TN 38201 Phone: 731-394-1145  | |
Briana Page Chandler, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 205 Hospital Dr Ste A, Mc Kenzie, TN 38201 Phone: 731-352-7907  |