Individual
DR. MALASY VICHATHEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-5000
Mailing address
8783 CALLAWAY CT, CORDOVA, TN 38016-1606
(615) 631-3885
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000188602
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
28085
TN
Other
Enumeration date
08/09/2012
Last updated
08/25/2020
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