Individual
MR. EVAN EDWARD FASSBENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-5000
Mailing address
519 S EDGEWOOD ST APT 201, MEMPHIS, TN 38104-4365
(251) 408-1824
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
194971
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
27968
TN
Other
Enumeration date
02/08/2020
Last updated
08/14/2020
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