Healthcare Provider Details

I. General information

NPI: 1760790034
Provider Name (Legal Business Name): GINGER LYNN GAKUNGA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINGER THOMPSON

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 US HIGHWAY 64 STE 103
BARTLETT TN
38133-4135
US

IV. Provider business mailing address

8350 US HIGHWAY 64 STE 103
BARTLETT TN
38133-4135
US

V. Phone/Fax

Practice location:
  • Phone: 901-730-6003
  • Fax:
Mailing address:
  • Phone: 901-730-6003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA006026
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14007
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14007
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: