| Kejac Ventures, PLLC, | |
|
9390 Mayfield Rd S Collierville TN 38017-3354 | |
| (901) 849-4108 | |
| Not Available |
| Full Name | Kejac Ventures, PLLC, |
|---|---|
| Speciality | Clinic/center |
| Location | 9390 Mayfield Rd S, Collierville, Tennessee |
| Authorized Official Name and Position | Leellon Louise Martin (NURSE PRACTITIONER) |
| Authorized Official Contact | 9018494108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kejac Ventures, PLLC, 9390 Mayfield Rd S Collierville TN 38017-3354 Ph: (901) 849-4108 | Kejac Ventures, PLLC, 9390 Mayfield Rd S Collierville TN 38017-3354 Ph: (901) 849-4108 |
| NPI Number | 1700779519 |
|---|---|
| Provider Enumeration Date | 05/30/2025 |
| Last Update Date | 05/30/2025 |
| Certification Date | 05/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700779519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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