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Individual

MARY SHAREE DEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP-BC

Contact information

Practice address
144 S THOMAS ST STE 202, TUPELO, MS 38801-5337
(662) 269-4453
Mailing address
144 S THOMAS ST STE 202, TUPELO, MS 38801-5337
(662) 269-4453
(662) 583-4018

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R803122
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00622390
MS
01
1154572857
INDIVIDUAL NPI
MS
01
1518237932
GROUP NPI
MS
01
R803122
BOARD OF NURSING
MS
Enumeration date
10/01/2008
Last updated
05/07/2025
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