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Individual

MARY KATHERINE FENNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
1620 WESTGATE CIR, BRENTWOOD, TN 37027-8035
(629) 255-2271
(629) 255-4279
Mailing address
222 22ND AVE N, NASHVILLE, TN 37203-1852
(629) 255-3486
(629) 255-3075

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
37653
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37653
APN LICENSE
TN
05
Q098661
TN
Enumeration date
04/19/2023
Last updated
01/17/2025
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