Mary Young, RN,BSN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN0000129473 Issued in TN

Practice address

10825 Old Highway 64
Bolivar, TN 38008-3599

Phone

(731) 658-5291

NPI assigned

Feb 5, 2015

Last updated

Feb 5, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1467843995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380080670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083599",
            "telephone_number": "731-658-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARY",
        "credential": "RN,BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "RN0000129473",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "RN0000129473",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Gregory Wilson, DDS
• Sherwin A Yaffe, M.D.
• Yn Pakkala M.D, P.C
• Amanda Megan Young Nibber, LPCC
• Janet M Young, R.N.

• Community Health Registered Nurse in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Community Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.