Provider Demographics
NPI:1780107219
Name:HOMAN, SAUNDRA GAIL (FNP)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:GAIL
Last Name:HOMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6490 MOUNT MORIAH ROAD EXT STE 200
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-3841
Mailing Address - Country:US
Mailing Address - Phone:901-565-0244
Mailing Address - Fax:901-565-0616
Practice Address - Street 1:6490 MOUNT MORIAH ROAD EXT STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-3841
Practice Address - Country:US
Practice Address - Phone:901-565-0244
Practice Address - Fax:901-565-0616
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNANP0000022689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily