Provider Demographics
NPI:1639556699
Name:HUTCHISON-GIBSON, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HUTCHISON-GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:NICOLE
Other - Last Name:HUTCHISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5050 POPLAR AVE
Mailing Address - Street 2:STE 800
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38157-0800
Mailing Address - Country:US
Mailing Address - Phone:901-276-2662
Mailing Address - Fax:901-274-2033
Practice Address - Street 1:3960 NEW COVINGTON PIKE
Practice Address - Street 2:CARDIOVASCULAR SERVICES
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2504
Practice Address - Country:US
Practice Address - Phone:901-516-5289
Practice Address - Fax:901-516-5173
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19896363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care