Individual
MS. MARY KATHLEEN FLACH QUISENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 HEALTH PARK DR STE 210, BRENTWOOD, TN 37027-5746
(615) 392-6050
Mailing address
1712 NATCHEZ TRCE, NASHVILLE, TN 37212-3329
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2021047999
MO
363AM0700X
Medical Physician Assistant
0010-09496
NC
363AM0700X
Medical Physician Assistant
Primary
6291
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000410200
—
FL
01
—
Y02CL
BLUE SHIELD
FL
Enumeration date
11/30/2006
Last updated
01/09/2026
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