Individual
DESERAY S MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
569 SKYLINE DR, JACKSON, TN 38301-3911
(731) 664-7395
Mailing address
569 SKYLINE DR, JACKSON, TN 38301-3911
(731) 664-7395
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200793
TN
363LF0000X
Family Nurse Practitioner
Primary
30302
TN
Other
Enumeration date
09/01/2021
Last updated
03/06/2025
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