Mary Lou Adams, NP
Individual provider Active NPI Nurse Practitioner · Jackson, TN
NPI 1346288503 · NPPES record last updated Jul 29, 2009
Key facts
- NPI
- 1346288503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APN5821 (TN)
- Practice address
- 708 W Forest Ave
Jackson, TN 38301-3901 - Phone
- (731) 660-8759
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5821 | TN | MD | Mental Health Counselor |
| APN5821 | TN | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN5821 | TN | Yes |
Addresses
Primary practice location
708 W Forest Ave
Jackson, TN 38301-3901
Mailing address
1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436
Phone (731) 660-8759
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3068438 | Other | BCBS |
Other providers in Jackson, TN
- Carrie Anne Ackroyd
- Acne & Rosacea Clinics
- Sonya Acuff
- Kaleb Adams
- Mary Allison Adams
- Trista Nicole Adams
- Alexander Aden
- Ezekiel Oladejo Adetunji
- Troy D Adkins
- William Bradford Adkins
All providers in Jackson, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.