Individual
MRS. MARY LOU CAMERON FORNEHED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP, BC
Contact information
Practice address
145 W 4TH ST STE 201, COOKEVILLE, TN 38501
(931) 783-2143
(931) 783-2152
Mailing address
140 W 7TH ST, COOKEVILLE, TN 38501-1726
(931) 783-5582
(931) 526-6760
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
6081
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530878
—
TN
01
—
4026322
BLUE CROSS PIN
TN
01
—
4346448
BCBS
TN
05
—
78013588
—
KY
Enumeration date
07/09/2006
Last updated
07/13/2022
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