Individual
MS. MARY K WETSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1029 W MAIN ST, SUITE M, LEBANON, TN 37087-3351
(615) 453-1252
(615) 453-1286
Mailing address
1029 W MAIN ST, SUITE M, LEBANON, TN 37087-3351
(615) 453-1252
(615) 453-1286
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN152241
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5441208
—
TN
Enumeration date
03/07/2007
Last updated
09/07/2012
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