Individual
MRS. MELISSA ANDREA HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5369 PIPERS GAP DR, MEMPHIS, TN 38134-6409
(901) 567-0450
Mailing address
5369 PIPERS GAP DR, MEMPHIS, TN 38134-6409
(901) 567-0450
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-0696563
—
TN
Enumeration date
10/18/2018
Last updated
10/18/2018
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