Individual
TANJALA TRINETTE GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
51 N DUNLAP ST STE 400, MEMPHIS, TN 38105-4625
(901) 287-7337
(901) 387-5143
Mailing address
850 POPLAR AVE BLDG 2, MEMPHIS, TN 38105-4607
(901) 287-5674
(901) 287-6804
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
54122
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
01/25/2007
Last updated
04/14/2018
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