Healthcare Provider Details

I. General information

NPI: 1306701701
Provider Name (Legal Business Name): VANESSA CHANTHY ECHOLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA CHANTHY COLLIER

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2668 BAY POINTE CIR E
MEMPHIS TN
38128-0920
US

IV. Provider business mailing address

2668 BAY POINTE CIR E
MEMPHIS TN
38128-0920
US

V. Phone/Fax

Practice location:
  • Phone: 901-264-1728
  • Fax:
Mailing address:
  • Phone: 901-264-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number40336
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: