Healthcare Provider Details

I. General information

NPI: 1780523837
Provider Name (Legal Business Name): ELANA MALKIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 POPLAR AVE STE 101
MEMPHIS TN
38119-4878
US

IV. Provider business mailing address

6515 POPLAR AVE STE 101
MEMPHIS TN
38119-4878
US

V. Phone/Fax

Practice location:
  • Phone: 404-884-8731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP332713
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: