Healthcare Provider Details

I. General information

NPI: 1508591140
Provider Name (Legal Business Name): JIE ZHANG MELTESEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E PARKWAY S
MEMPHIS TN
38104-5568
US

IV. Provider business mailing address

2683 DIBRELL TRAIL DR
COLLIERVILLE TN
38017-8981
US

V. Phone/Fax

Practice location:
  • Phone: 901-321-3388
  • Fax:
Mailing address:
  • Phone: 312-515-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6491
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: