Provider Demographics
NPI:1336648534
Name:HASTINGS, MELISSA MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DAVID COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-2813
Mailing Address - Country:US
Mailing Address - Phone:615-355-6175
Mailing Address - Fax:
Practice Address - Street 1:108 DAVID COLLINS DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2813
Practice Address - Country:US
Practice Address - Phone:615-355-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000201656163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse