Provider Demographics
NPI:1912464447
Name:HIXSON, MELISSA GAIL (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:GAIL
Last Name:HIXSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:HIXSON
Other - Last Name:RANDLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2253 CHAMBLISS AVE NW STE 301
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3961
Mailing Address - Country:US
Mailing Address - Phone:423-476-4466
Mailing Address - Fax:423-476-4487
Practice Address - Street 1:2253 CHAMBLISS AVE NW STE 301
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3961
Practice Address - Country:US
Practice Address - Phone:423-476-4466
Practice Address - Fax:423-476-4487
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000025399363LF0000X
GA276366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily