Individual
MARY YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BSN
Contact information
Practice address
10825 OLD HIGHWAY 64, BOLIVAR, TN 38008-3599
(731) 658-5291
Mailing address
PO BOX 670, BOLIVAR, TN 38008-0670
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000129473
TN
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN0000129473
TN
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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