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Individual

DR. MARILYN BODIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD.,APRN-BC

Contact information

Practice address
511 8TH ST, CLARKSVILLE, TN 37040-3093
(931) 920-7200
Mailing address
3020 SEVEN MILE FERRY RD, CLARKSVILLE, TN 37040-8304
(931) 920-7200

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN 6123
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
377032
MANAGED HEALTH NETWORK
TN
05
3903973
TN
01
4017181
BLUSCROSS BLUE SHIELD
TN
01
620718880001
CHAMPUS TRICARE
TN
Enumeration date
03/01/2007
Last updated
07/09/2007
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