Provider Demographics
NPI:1548848989
Name:THORNTON, TEMPEST TERESE'
Entity type:Individual
Prefix:
First Name:TEMPEST
Middle Name:TERESE'
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3246 COTTON BALE LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-8967
Mailing Address - Country:US
Mailing Address - Phone:901-230-2293
Mailing Address - Fax:
Practice Address - Street 1:3246 COTTON BALE LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-8967
Practice Address - Country:US
Practice Address - Phone:901-230-2293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist