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Individual

MALEAH VICTORIA WASHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1114 FAIRGROUNDS CT, KINGSTON, TN 37763-2657
(865) 919-4783
(865) 674-4422
Mailing address
1114 FAIRGROUNDS CT, KINGSTON, TN 37763-2657
(865) 919-4783
(865) 674-4422

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
246088
TN

Other

Enumeration date
12/14/2022
Last updated
12/14/2022
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