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Individual

MRS. CHANTE SMITH FASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, APRN, PMHNP

Contact information

Practice address
6005 PARK AVE STE 630B, MEMPHIS, TN 38119-5226
(901) 767-1136
(901) 767-0436
Mailing address
5821 PARK AVE, MEMPHIS, TN 38119-5134
(901) 450-3995
(901) 450-3993

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN0000007696
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7696
TN
363LP2300X
Primary Care Nurse Practitioner
APN0000007696
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1519348
TN
Enumeration date
12/11/2006
Last updated
01/30/2026
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