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Individual

JENNIFER L MABRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
228 W 4TH ST, STE 200, COOKEVILLE, TN 38501-2488
(931) 372-0405
(931) 372-0463
Mailing address
228 W 4TH ST, STE 200, COOKEVILLE, TN 38501-2488
(931) 372-0405
(931) 372-0463

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN96949
TN
363L00000X
Nurse Practitioner
Primary
APN6851
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3906449
TN
Enumeration date
08/09/2005
Last updated
09/10/2007
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